急性冠状动脉综合征患者血浆微囊泡浓度及其与冠状动脉粥样硬化斑块稳定性的相关性分析

摘要

目的 探讨急性冠状动脉综合征(ACS)患者血浆微囊泡浓度及其与冠状动脉粥样硬化斑块稳定性的相关性.方法 选取2012年1月—2016年12月收治的108例ACS患者以及同期40例正常体检者(对照组)作为研究对象.并根据ACS患者冠状动脉粥样硬化斑块检查情况分为斑块稳定组24例和斑块不稳定组84例.对比所有研究对象的血浆微囊泡浓度、C反应蛋白(CRP)、基质金属蛋白酶-1(MMP-1)、金属蛋白酶组织抑制剂-1(TIMP-1)水平以及ACS患者的冠状动脉粥样硬化斑块情况,并分析CRP、MMP-1和血浆微囊泡与冠状动脉粥样硬化斑块的相关性.结果 斑块不稳定组和斑块稳定组的CRP、MMP-1、TIMP-1和血浆微泡囊浓度均明显高于对照组,且斑块不稳定组的CRP、MMP-1和血浆微囊泡浓度较斑块稳定组高(P<0. 05).斑块不稳定组的脂核与斑块比、脂核或无回声带面积均大于斑块稳定组,而面积狭窄率、纤维帽厚度均小于斑块稳定组(P<0. 01). CRP、MMP-1和血浆微囊泡与脂核与斑块比、脂核或无回声带面积呈正相关,与面积狭窄率、纤维帽厚度呈负相关( P<0. 05).结论 ACS患者的血浆微囊泡浓度较正常人群明显升高,且与冠状动脉粥样硬化斑块稳定性相关.%Objective To investigate correlation between plasma microvesicle concentration with coronary ather-osclerotic plaque stability in patients with acute coronary syndrome (ACS). Methods A total of 108 ACS patients ad-mitted during January 2012 and December 2016 were divided into stable plaque group ( n =24) and unstable plaque group (n=84) according to conditions of coronary atherosclerotic plaques, and other 40 healthy people taking physical examination at the same period were selected as control group. Plasma microvesicle concentration, C-reactive protein (CRP), matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase-1 (TIMP-1) levels and conditions of coronary atherosclerotic plaque were compared, and correlations between CRP, MMP-1 and plasma microvesicles with coronary atherosclerotic plaques were also analyzed in all groups. Results Value of CRP, MMP-1, TIMP-1 and plasma microvesicle concentration in unstable and stable plaque groups were significantly higher than those in control group, and values of CRP, MMP-1 and plasma microvesicle concentration in unstable plaque group were significantly higher than those in stable plaque group (P<0. 05). In unstable plaque group, ratio of lipid to plaque and area of lipid or non-echo were significantly higher, while values of area stenosis rate and thickness of fibrous cap were significantly lower than those in stable plaque group (P<0. 01). CRP, MMP-1 and plasma microvesicles were positively correlated with ratio of lipid to plaque and area of lipid or non-echo, and they were negatively correlated with area stenosis rate and thickness of fi-brous cap (P<0. 05). Conclusion Plasma microvesicle concentration in ACS patients can be found significantly higher than that in normal population, and it is associated with stability of coronary atherosclerotic plaques.