利用IVUS-VH探讨踝臂指数升高的不稳定型心绞痛患者冠脉病变特点的研究

摘要

Objective To investigate the characteristics of coronary lesion in patients with unstable angina ( UA ) and ankle-brachial index( ABI ) by intravascular ultrasound-virtual histology( IVUS-VH ) technology. Methods A total of 137 patients were divided into normal ABI group ( 0. 9 = ABI=1.4) and elevated ABI group ( ABI > 1.4 ) according to ABI test results. All the patients underwent coronary angiography ( CAG ), IVUS and ABI examination. Then, plaque characteristics of culprit lesions were analyzed by IVUS-VH. Results The age, prevalence of hypertension, incidence of diabetes and smoking, serum creatinine, total cholesterol levels of the elevated ABI group were significantly different from those of normal ABI group. The lesion distributions and regions showed no significant difference between the two groups. IVUS-VH examinations indicated that the plaque length and percentage of calcification of the elevated ABI group were higher than those of the normal ABI group, and that the necrotic core percentage, number of vulnerable plaque, plaque rupture, thrombosis , and vascular remodeling index of elevated ABI group were lower. Logistic regression analysis showed that age, hypertension, diabetes, and smoking were correlated with the increase in ABI ( ABI > 1.4 ). Age, diabetes and the increase in ABI were correlated with calcification and lesion length. Conclusion The increase in ABI in patients with UA is correlated with coronary artery plaque calcification and lesion length.%目的 利用冠状动脉血管内超声及虚拟组织成像技术(IVUS-VH)探讨踝臂指数(ABI)升高的不稳定型心绞痛(UA)患者冠脉病变特点.方法 137例UA患者依据ABI检查结果分为ABI正常组(0.9≤ABI≤1.4)及ABI升高组(ABI>1.4),所有患者行冠状动脉造影(CAG)、IVUS及ABI检查,分析患者冠脉病变特点.结果 ABI升高组年龄、高血压、糖尿病患病率、吸烟比例、血肌酐、总胆固醇水平高于ABI正常组.病变血管分布及病变部位两组相比差异无统计学意义.IVUS-VH检查,斑块长度、钙化百分比ABI升高组高于ABI正常组;坏死核心百分比、易损斑块数、斑块破裂血栓、血管重构指数ABI升高组低于ABI正常组,两组比较差异有统计学意义.Logistic 回归分析,年龄、高血压、糖尿病、吸烟同ABI升高(ABI>1.4)相关.年龄、糖尿病和ABI升高与冠脉钙化、病变长度相关.结论 ABI升高同UA冠状动脉斑块钙化、病变长度增加相关.