摘要
目的探讨冠状动脉(冠脉)粥样硬化性心脏病(冠心病)患者冠状动脉粥样硬化斑块特征的差异及其与血清血小板活化因子(platelet activating factor,PAF)、脂蛋白相关磷脂酶2(lipoprotein related phospholipase 2,LP-PLA2)、血小板源性生长因子(platelet-derived growth factor,PDGF)浓度的关系。方法选取南京医科大学附属南京医院2016年2月至2017年9月确诊的168例冠心病患者,其中急性冠脉综合征(acute coronary syn?drome,ACS)患者98例(ACS组)、稳定型心绞痛(stable angina pectoris,SAP)患者70例(SAP组)。用血管内超声检测两组患者的斑块性质,实验室检测血清PAF、PDGF、LP-PLA2浓度,并分析PAF、PDGF、LP-PLA2与斑块性质参数的关系。结果 ACS组患者的软斑块发现率高于SAP组,差异有统计学意义[59.18%(58/98)vs.25.71%(18/70),χ2=18.464,P<0.05]。ACS组和SAP组患者的病变斑块外弹力膜面积、管腔面积测定值比较,差异无统计学意义(P<0.05)。ACS组患者的斑块面积、偏心指数均显著高于SAP组患者,差异有统计学意义(P<0.05)。ACS组患者的血清PAF、PDGF、LP-PLA2浓度均高于SAP组,差异具有统计学意义(P<0.05)。软斑块组冠心病患者的血清PAF、PDGF、LP-PLA2浓度均高于硬斑块组,差异具有统计学意义(P<0.05)。冠心病患者的冠状动脉斑块偏心指数与血清PAF、PDGF、LP-PLA2浓度均呈显著的正相关关系(P<0.05)。结论通过观察冠状动脉粥样硬化斑块及血清PAF、PDGF、LP-PLA2浓度,可以对患者的病情进行评估。血清PAF、PDGF、LP-PLA2浓度与斑块的性质及不稳定性有关。
Objectives To investigate the characteristics of coronary atherosclerotic plaque in patients with coronary heart disease and its relationships with serum concentrations of platelet activating factor(PAF),lipoprotein related phospholipase 2(LP-PLA2)and platelet-derived growth factor(PDGF).Methods Totally 168 patients with coronary heart disease diagnosed in The Affiliated Nanjing Hospital of Nanjing Medical University from February 2016 to September 2017 were selected.Among them,98 patients with acute coronary syndrome(ACS group)and 70 patients with stable angina pectoris(SAP group)were compared.Intravascular ultrasound was used to detect plaque properties in these patients.Serum concentrations of PAF,PDGF,and LP-PLA2 were tested.Relationships between PAF,PDGF,LP-PLA2 and the nature parameters of the plate were analyzed.Results The detection rate of soft plaque in ACS patients was higher than that in SAP group[59.18%(58/98)vs.25.71%(18/70),χ^2=18.464,P<0.05].There was no significant difference in the area of external elastic membrane and lumen area between lesions in ACS and SAP patients(P<0.05).The plaque area and eccentricity index of ACS group were significantly higher than those of SAP group(P<0.05).Serum concentrations of PAF,PDGF and LP-PLA2 in ACS group were significantly higher than those in SAP group(P<0.05).Serum concentrations of PAF,PDGF and LP-PLA2 in patients with coronary heart disease in soft plaque group were higher than those in patients with coronary heart disease in hard plaque group(P<0.05).There were significant positive correlations between plaque eccentricity index and serum concentrations of PAF,PDGF,and LPPLA2(P<0.05).Conclusions Patients′s condition can be judged by observing coronary atherosclerosis plaques and serum concentrations of PAF,PDGF and LP-PLA2.Serum concentrations of PAF,PDGF,LP-PLA2 are related with the properties and instabilities of coronary atherosclerotic plaques.
作者
王璇
贾海波
WANG Xuan;JIA Hai-bo(Department of Geriatric Medicine,The Affiliated Nanjing Hospital of Nanjing Medical University,Nanjing210000,China)
出处
《岭南心血管病杂志》
2019年第1期24-27,共4页
South China Journal of Cardiovascular Diseases
关键词
冠状动脉疾病
动脉粥样硬化斑块
血小板活化因子
脂蛋白相关磷脂酶2
血小板源性生长因子
coronary heart disease
coronary atherosclerotic plaque
platelet activating factor
lipoprotein-related phospholipase 2
platelet-derived growth factor
作者简介
王璇(1987-),女,主治医师,研究方向为老年心血管病诊治;通信作者:贾海波.
