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目的:应用血管内超声(IVUS)比较急性心肌梗死(AMI)和稳定型心绞痛(SAP)患者冠状动脉斑块特征。方法:AMI组患者45例和SAP组患者50例,接受冠状动脉造影及 IVUS检查。通过 IVUS评价斑块偏心指数、钙化、夹层/破裂、血栓、重构、斑块长度及面积等特征。结果: 两组患者斑块偏心指数及钙化差异无统计学意义,但AMI组血栓(20%)、夹层/破裂(33.3%)、正性重构(81.3%)、低回声斑块(64.4%)明显高于 SAP组分别为0,4.0%,53.4%,28.0%,P<0.05 或0.01;AMI组斑块长度[(17.2±9.8)mm]、斑块面积[(12.4±5.9)mm2]较SAP组[分别为(10.3±6.2)mm,(9.1±4.3 )mm2 ]差异有统计学意义(P<0.05 或 0.01)。结论:血栓、夹层/破裂、正性重构、较长斑块长度、较大斑块负荷及低回声斑块为 AMI患者梗死相关斑块的特征,AMI发生与事件前斑块特征有关。
Objective: To compare the characteristics of coronary plaque in patients with acute myocardial infarction (AMI) and stable angina pectoris (SAP) by intravascular ultrasound (IVUS). Methods: 45 patients in AMI group and 50 patients in SAP group underwent coronary angiography and IVUS examination. IVUS was used to evaluate features such as plaque eccentricity, calcification, dissection / disruption, thrombosis, remodeling, plaque length and area. Results: There was no significant difference in plaque eccentricity index and calcification between the two groups, but thrombus (20%), dissection / rupture (33.3%), positive remodeling (81.3%), hypoechoic plaque (64.4% ) Were significantly higher than those in SAP group (0,4.0%, 53.4%, 28.0%, P <0.05 or 0.01 respectively). The length of plaque in AMI group was (17.2 ± 9.8) mm and the area of plaque was (12.4 ± 5.9) mm2 The difference was statistically significant (P <0.05 or 0.01) compared with SAP group [(10.3 ± 6.2) mm, (9.1 ± 4.3) mm2], respectively. Conclusions: Thrombosis, dissection / rupture, positive remodeling, longer plaque length, larger plaque burden and hypoechoic plaque are the characteristics of infarct-related plaques in AMI patients. The occurrence of AMI is related to plaque characteristics before the event.