64排螺旋CT联合高敏C反应蛋白、基质金属蛋白酶-9法在冠脉斑块性质检测中的应用

摘要

目的：本文研究64排CT冠脉成像联合高敏C反应蛋白（hs-CRP）及基质金属蛋白酶-9（MMP-9）法在急性冠脉综合征（ACS）患者易损斑块检测中的应用价值。方法选取2014年9月～2015年3月在我院治疗的冠脉斑块（均为单发的冠心病）患者共计112例。依据冠心病的病情选取稳定性心绞痛（SAP）患者作为观察组1（50例），ACS患者作为观察组2（62例），另取KPS评分≥90分的健康患者86例作为对照组。对3组患者进行64层螺旋CT冠脉成像扫描，观察患者hs-CRP、MMP-9浓度及动脉斑块分布情况。结果观察组1、观察组2患者较对照组hs-CRP、MMP-9浓度升高明显（P＜0.05），观察组2浓度高于观察组1（P＜0.05）；观察组2软斑块发现率高于观察组1（P＜0.05）；所有冠心病患者hs-CRP与MMP-9浓度与检测的CT值均为负相关（P＜0.05）。结论 hs-CRP、MMP-9联合CT冠脉成像法在检测ACS患者易损斑块中的应用效果良好，大大提高了ACS的诊断准确率。%Objective To explore the effectiveness of combination of application of 64-row spiral CT coronary artery imaging, high sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9) in detection of vulnerable plaques in patients with acute coronary syndromes (ACS). Methods A total of 112 cases of hospitalized patients with coronary heart disease (CHD) who had single coronary plaque and were treated in the hospital between September 2014 and March 2014 were selected and divided into two groups (Observation 1 Group, Observation 2 Group and Control Group) according to the condition of CHD. Among all the patients, 50 cases of patients with stable angina pectoris (SAP) were selected as Observation 1 Group, 62 patients with ACS as Observation 2 Group, 86 cases of healthy patients whose KPS (Karnofsky Performance Score) ≥ 90 points as Control Group. The three groups of patients were scanned by using 64-row spiral CT coronary artery imaging so as to observe the concentration of hs-CRP and MMP-9 and the distribution of arterial plaques. Results Compared with Control Group, Observation 1 Group and Observation 2 Group showed obviously increasing hs-CRP and MMP-9 concentrations (P<0.05), among which Observation 2 Group had the highest concentration (P<0.05); more soft plaques were found in Observation 2 Group than Control Group (P<0.05); hs-CRP and MMP-9 concentrations of all patients with CHD were negatively correlated with CT values (P<0.05). Conclusion Combination of application of hs-CRP, MMP-9 and CT coronary imaging showed excellent effectiveness in detection of vulnerable plaques in patients with ACS, which greatly improved the accuracy in diagnosis of ACS.