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[心绞痛患者血清炎症因子与动脉粥样硬化斑块血管内超声特征的相关性研究]

[A correlation study of serum inflammatory factors and intravascular ultrasound features of atherosclerotic plaques in patients with angina pectoris].

作者信息

Chen Wen-Qiang, Zhang Yun, Zhang Mei, Ji Xiao-Ping, Ding Shi-Fang, Chen Yu-Guo, Li Gui-Shuang, Li Da-Qing, Su Hai-Jun

机构信息

Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2004 Jul 2;84(13):1062-5.

Abstract

OBJECTIVE

To elucidate the relationship between serum inflammatory factors and intravascular ultrasound (IVUS) findings of atherosclerotic plaques in patients with stable and unstable angina.

METHODS

Thirteen patients with stable angina (SA) in group A and nineteen patients with unstable angina (UA) in group B underwent study. Concentrations of hsCRP, sVCAM-1 and sICAM-1 were measured by means of Enzyme-Linked-Immunosorbent Assay (ELISA) and IVUS was used to analysis the coronary lesions. Their results were analyzed by correlate analysis.

RESULTS

Concentration of hsCRP, sVCAM-1 and sICAM-1 were significantly higher in group B (4.7 mg/L +/- 2.6 mg/L, 789 micro g/L +/- 65 micro g/L and 365 micro g/L +/- 63 micro g/L) than in group A (2.4 mg/L +/- 1.8 mg/L, 544 micro g/L +/- 70 micro g/L and 264 micro g/L +/- 53 micro g/L, P < 0.01, respectively). IVUS found that 69.2% (18/26) patients in group B had soft lipid plaques, while patients in group A mainly had fibrous and mixed plaques, only 13.3% (2/15) had soft plaques. There were more eccentric plaques and EEMA in group B than in group A (P < 0.05, respectively), and PA and lumen area stenosis ratio (LAS) in group B were larger than those of group A (P < 0.01, respectively). Positive remodeling pattern was observed in 65.4% (17/26) lesions in group B while 66.6% (10/15) lesions in group A showed negative remodeling. sICAM-1 correlated well with RI (r = 0.475, P < 0.05) and C-RP with EEMA (r = 0.448, P < 0.05).

CONCLUSION

High levels of hsCRP, sVCAM-1 and sICAM-1 are sensitive predictors of unstable angina. The features of unstable atherosclerotic plaques are eccentric, soft plaques, with large plaque areas. The vessel at the lesion shows positive remodeling. Inflammatory reaction correlated well with vascular enlargement and remodeling.

摘要

目的

阐明稳定型和不稳定型心绞痛患者血清炎症因子与动脉粥样硬化斑块血管内超声(IVUS)表现之间的关系。

方法

对A组13例稳定型心绞痛(SA)患者和B组19例不稳定型心绞痛(UA)患者进行研究。采用酶联免疫吸附测定(ELISA)法检测超敏C反应蛋白(hsCRP)、可溶性血管细胞黏附分子-1(sVCAM-1)和可溶性细胞间黏附分子-1(sICAM-1)的浓度,并使用IVUS分析冠状动脉病变。通过相关性分析对结果进行分析。

结果

B组hsCRP、sVCAM-1和sICAM-1的浓度(分别为4.7 mg/L±2.6 mg/L、789 μg/L±65 μg/L和365 μg/L±63 μg/L)显著高于A组(分别为2.4 mg/L±1.8 mg/L、544 μg/L±70 μg/L和264 μg/L±53 μg/L,P均<0.01)。IVUS发现,B组69.2%(18/26)的患者有软脂斑块,而A组患者主要为纤维斑块和混合斑块,仅有13.3%(2/15)有软斑块。B组偏心斑块和外膜-中膜面积(EEMA)比A组更多(P均<0.05),B组斑块面积(PA)和管腔面积狭窄率(LAS)大于A组(P均<0.01)。B组65.4%(17/26)的病变观察到正性重构,而A组66.6%(10/15)的病变表现为负性重构。sICAM-1与重构指数(RI)相关性良好(r = 0.475,P < 0.05),C反应蛋白(C-RP)与EEMA相关性良好(r = 0.448,P < 0.05)。

结论

hsCRP、sVCAM-1和sICAM-1的高水平是不稳定型心绞痛的敏感预测指标。不稳定动脉粥样硬化斑块的特征为偏心、软斑块、斑块面积大。病变处血管表现为正性重构。炎症反应与血管扩张和重构相关性良好。

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