摘要
目的探讨稳定性心绞痛患者冠状动脉粥样硬化斑块性质与颈动脉斑块的相关性。进一步分析颈动脉粥样硬化与冠心病临界病变及不同斑块性质关系。方法选择在我院行冠状动脉造影及PCI患者,并显示为临界病变者行血管内超声检查评估斑块特征,按冠状动脉斑块性质将242例患者分为薄帽纤维粥样斑块(TCFA)组113例,厚帽纤维粥样斑块(ThCFA)组90例,病理性内膜增厚(PIT)组39例。分析稳定性心绞痛患者危险因素。结果稳定性心绞痛患者冠状动脉粥样硬化斑块以TCFA组病例最多,为46.69%,ThCFA组为37.19%,PIT组为16.12%。TCFA组糖尿病(30.09%vs 26.67%、12.82%)、脑血管事件(16.81%vs 6.67%、5.13%)、高密度钙化面积[(11.3±8.4)%vs(3.4±3.3)%、(1.3±1.0)%]、最小管腔面积≤4.0mm2(17.7%vs 7.8%、15.4%)比例显著高于ThCFA组和PIT组(P<0.05,P<0.01)。3组双侧颈动脉斑块比较,TCFA组显著高于ThCFA组和PIT组(38.1%vs 25.6%、18.0%,P<0.01)。结论稳定性心绞痛患者冠状动脉粥样硬化斑块性质以TCFA类型为主,其冠状动脉斑块钙化成分、双侧颈动脉斑块比例、脑血管事件发生率更高。
Objective To study the relationship between coronary atherosclerotic plaque characterics and carotid plaques in stable angina pectoris patients.Methods Two hundred and forty-two patients who underwent coronary angiography and PCI in our hospital were divided into thin cap fibroatherosclerotic plaque（TCFAP）group（n=113）,thick cap fibroatherosclerotic plaque（ThCFAP）group（n=90）,and pathological intimal thickening（PIT）group（n=39）.Their risk factors for stable angina pectoris were analyzed.Results The incidence of coronary atherosclerotic plaques was 46.69%,37.19%and 16,12%respectively in TCFAP group,ThCFAP group and PIT group.The incidence of diabetes mellitus and cerebrovascular events,and the proportion of high density calcified area and minimal lumen area≤4.0mm^2 were significantly higher in TCFAP group than in ThCFAP group and PIT group（30.09% vs 26.67% and 12.82%,16.81% vs 6.67% and5.13%,11.3%±8.4% vs 3.4%±3.3% and 1.3% ±1.0%,17.7% vs 7.8% and 15.4%,P〈0.05,P〈0.01）.The incidence of bilateral carotid plaques was significantly higher in TCFAP group than in ThCFAP group and PIT group（38.1%vs 25.6%and 18.0%,P〈0.01）.Conclusion Coronary atherosclerotic plaques in stable angina pectoris patients are characterized by TCFAP with a high incidence of high density calcified coronary plaques,bilateral carotid plaques and cerebrovascular events.
作者
赵志宏
马瑛
王赛华
罗俊
宁忠平
郑昌柱
李新明
ZHAO Zhi-hong MA Ying WANG Sai-hua et al(Department of Cardiology ,Affiliated Zhoupu Hospital of Shanghai Health and Medical College ,Shanghai 201318 ,China)
出处
《中华老年心脑血管病杂志》
CAS
2017年第3期264-268,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
上海市医学重点专科建设计划基金(ZK2015A17)
上海市浦东新区周浦医院重中之重建设专项基金(ZP2014A-01)
关键词
心绞痛
动脉粥样硬化
颈动脉疾病
冠状血管造影术
angina pectoris
atherosclerosis
carotid artery diseases
coronary angiography
