64排多层螺旋CT冠状动脉成像比较稳定性与不稳定性心绞痛患者冠状动脉粥样硬化斑块特征

摘要

目的 探讨64排多层螺旋CT冠状动脉成像比较稳定性心绞痛(SAP)与不稳定性心绞痛(UAP)患者粥样硬化斑块的特征.方法 对40例SAP患者、40例UAP患者进行64排多层螺旋CT冠状动脉成像,比较两组患者冠脉斑块的数量及斑块类型.对其中50例患者(26例UAP,24例SAP)罪犯斑块特征进行比较.结果 SAP组患者与UAP组患者斑块数量比较无显著性差异.UAP组患者非钙化性斑块、混合性斑块发生率较高.在对两组患者罪犯斑块特征进行比较的亚组分析中,UAP患者罪犯斑块非钙化性斑块、血管正性重构发生率以及血管重构指数明显高于SAP患者,在校正了年龄、性别、高血压病、糖尿病、高脂血症、吸烟等危险因素后,非钙化性斑块、血管正性重构与UAP显著相关.结论 64排多层螺旋CT冠状动脉成像显示:与SAP患者比较,UAP患者非钙化性斑块与混合性斑块发生率较高,罪犯斑块具有较高的非钙化性斑块及正性重构发生率.%Objective To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris(UAP) and stable angina pectoris(SAP) by multislice computed tomographic angiography.Methods 40 patients with UAP and 40 patients with SAP underwent 64-slice MSCT.The number and phenotypes of coronary plaques were compared.In a sub-analysis of culprit plaques characteristics in 50 patients (26 with UAP,24 with SAP), culprit plaques phenotypes ,positive remodeling, remodeling index and spotty calcification were determined.Results In the CT profile of UAP and SAP patients,the number of plaques was not different, noncalcified plaques and mixed plaques were significantly more frequent in patients with UAP.In the culprit plaques sub-analysis ,after adjusting for clinical variables ,noncalcified plaques 、positive remodeling were significantly related to the culprit plaques of UAP patients.Conclusions 64-slice computed tomographic angiography demonstrates a higher prevalence of noncalcified plaques and mixed plaques in patients with UAP compared with SAP patients.Noncalcified culprit plaques and positive remodling are more frequently found in patients with UAP than in those with SAP.