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在稳定性冠心病患者中,采用 64 层多排螺旋 CT 评价炎症标志物与冠状动脉斑块形态和程度的相关性。

Association of inflammatory markers with the morphology and extent of coronary plaque as evaluated by 64-slice multidetector computed tomography in patients with stable coronary artery disease.

机构信息

Department of Cardiology, Chubu Rosai Hospital, 10-6, 1-Chome Komei-cho, Minato-ku, Nagoya 455-8530, Japan.

出版信息

Int J Cardiovasc Imaging. 2013 Jun;29(5):1149-58. doi: 10.1007/s10554-013-0181-2. Epub 2013 Jan 29.

DOI:10.1007/s10554-013-0181-2
PMID:23358918
Abstract

We evaluated the association between inflammatory markers and coronary artery plaque assessed by 64-slice multidetector computed tomography. Coronary computed tomography angiography was performed in patients with chest discomfort suggestive of coronary artery disease (CAD). Individuals with an acute coronary syndrome were excluded from the study. Coronary plaque morphology, the number of artery segments exhibiting plaque, and the number of vessels with >50% stenosis were evaluated. Plasma levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), plasminogen activator inhibitor-1, and vascular endothelial growth factor were measured. Among the 178 patients studied (age 65 ± 10 years; 70% men), 125 were diagnosed with CAD. Hs-CRP and IL-6 concentrations were significantly higher in patients with CAD than in patients without (2.73 ± 4.7 vs. 1.32 ± 2.6 mg/L, P = 0.018, and 3.06 ± 3.3 vs. 2.19 ± 2.4 pg/mL, P = 0.036). The IL-6 level was high in patients with predominantly calcified plaque, and was significantly higher in patients with 4-9 plaque segments than in those with no or 1-3 plaque segments (4.07 ± 5.3 vs. 2.19 ± 2.4 pg/mL and 2.43 ± 2.0 pg/mL, respectively, P = 0.025). The number of stenotic vessels was not significantly related to inflammatory markers. Multivariate logistic analysis revealed that plasma levels of hs-CRP but not IL-6 were associated with the presence of coronary plaque with calcification (OR 3.37, P = 0.026). This study supports the usefulness of inflammatory markers for the evaluation of coronary plaque in patients with stable CAD.

摘要

我们评估了 64 层多排螺旋 CT 检测到的炎症标志物与冠状动脉斑块之间的相关性。对有胸痛症状提示冠心病(CAD)的患者进行冠状动脉 CT 血管造影。排除有急性冠状动脉综合征的患者。评估冠状动脉斑块形态、有斑块的动脉节段数和 >50%狭窄的血管数。测量高敏 C 反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、纤溶酶原激活物抑制剂-1 和血管内皮生长因子的血浆水平。在研究的 178 名患者(年龄 65 ± 10 岁;70%为男性)中,125 名被诊断为 CAD。CAD 患者的 hs-CRP 和 IL-6 浓度明显高于无 CAD 患者(2.73 ± 4.7 比 1.32 ± 2.6mg/L,P = 0.018 和 3.06 ± 3.3 比 2.19 ± 2.4pg/mL,P = 0.036)。主要为钙化斑块的患者 IL-6 水平较高,且 4-9 个斑块节段的患者明显高于无或 1-3 个斑块节段的患者(4.07 ± 5.3 比 2.19 ± 2.4pg/mL 和 2.43 ± 2.0pg/mL,P = 0.025)。狭窄血管数与炎症标志物无显著相关性。多变量逻辑分析显示,hs-CRP 而非 IL-6 血浆水平与冠状动脉钙化斑块的存在相关(OR 3.37,P = 0.026)。本研究支持炎症标志物在评估稳定型 CAD 患者冠状动脉斑块方面的作用。

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