[光学相干断层扫描对不稳定型心绞痛和稳定型心绞痛患者动脉粥样硬化斑块的特征分析]

[Characterization of atherosclerotic plaque in patients with unstable angina pectoris and stable angina pectoris by optical coherence tomography].

作者信息

Chen Bu-xing, Ma Feng-yun, Luo Wei, Ruan Jian-hong, Zhao Xi-zhe, Xie Wen-li, Sun Shu-hong, Guo Xu-mei, Wang Feng, Tian Ting, Chu Xiao-wen

机构信息

Department of Cardiology, Beijing Electric Power Hospital, Beijing, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2009 May;37(5):422-5.

PMID:19781218

Abstract

OBJECTIVE

To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT).

METHODS

OCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by > or = 2 quadrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients.

RESULTS

OCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs. 73% (16/22), P = 0.741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5 +/- 34.7) microm vs. (141.1 +/- 68.5) microm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P = 0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22), P = 0.000] and plaque rupture [50% (11/22) vs. 9% (2/22), P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups.

CONCLUSIONS

OCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.

摘要

目的

通过光学相干断层扫描（OCT）比较不稳定型心绞痛（UAP）和稳定型心绞痛（SAP）患者冠状动脉粥样硬化斑块的特征。

方法

对47例行冠状动脉造影的患者（23例UAP和24例SAP）进行OCT检查。比较UAP和SAP患者中富含脂质斑块（由横截面面积的≥2个象限定义）、薄帽纤维粥样瘤（TCFA）、纤维帽厚度、斑块破裂、钙化和OCT显示的血栓情况。

结果

47例患者中有44例（22例UAP，22例SAP）成功完成OCT成像。UAP组和SAP组中富含脂质斑块的比例相似[91%（20/22）对73%（16/22），P = 0.741]。UAP组纤维帽的最小厚度明显薄于SAP组[（69.5±34.7）微米对（141.1±68.5）微米，P = 0.000]，且UAP组纤维帽侵蚀率明显高于SAP组[59%（13/22）对9%（2/22），P = 0.000]。与SAP组相比，UAP组的TCFA百分比[73%（16/22）对14%（3/22），P = 0.000]和斑块破裂百分比[50%（11/22）对9%（2/22），P = 0.003]明显更高。两组间血栓和钙化的发生率相似。