本文關(guān)鍵詞： 血管內(nèi)超聲 血清脂蛋白相關(guān)磷脂酶A2 冠心病　出處：《鄭州大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的采用血管內(nèi)超聲-虛擬組織學(xué)成像技術(shù)(VH-IVUS)對(duì)冠心病患者的斑塊進(jìn)行分析,并明確斑塊性質(zhì)和血清脂蛋白相關(guān)磷脂酶A2.(Lipoprotein-associated phospholipase A2.Lp-PLA2)之間的相關(guān)程度。方法1、根據(jù)標(biāo)準(zhǔn)挑選有冠心病的病人總?cè)藬?shù)為115人,穩(wěn)定型心絞痛(Stable Angina,SA)病人為54人,急性冠脈綜合征(Acute Coronary Syndrome,ACS)的病人占61人,空白對(duì)照組則為52人,明確診斷。2、對(duì)造影過程中選取的目標(biāo)行血管內(nèi)超聲檢查,并記錄檢查的結(jié)果及灰階圖像以利于后期分析和研究。3、通過檢測得到研究對(duì)象血清脂蛋白相關(guān)磷脂酶A2、超敏C-反應(yīng)蛋白.(high sensitivity C-reactive protein)等常規(guī)血液指標(biāo)的水平。4、通過統(tǒng)計(jì)手段對(duì)血清脂蛋白相關(guān)磷脂酶A2、超敏C-反應(yīng)蛋白與斑塊成分進(jìn)行相關(guān)性分析。結(jié)果1三組患者的一般情況不存在統(tǒng)計(jì)學(xué)上的差異;2 VH-IVUS結(jié)果顯示:ACS組血管重塑指數(shù)、壞死核心(necrotic core,NC)、斑塊偏心指數(shù)均高于SA組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),斑塊中FF與纖維組織(fibrous tissue,FT)比例均低于SA組,差異有統(tǒng)計(jì)學(xué)差異(P0.05)3 ACS組患者血清脂蛋白相關(guān)磷脂酶A2、超敏C-反應(yīng)蛋白水平明顯高于SA組及對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)4 ACS組血清Lp-PLA2水平與斑塊中NC所占比例、血管重塑指數(shù)、斑塊偏心指數(shù)呈正相關(guān)(r=0.736,P=0.016;r=0.651,P=0.024;r=0.719,P=0.027)。結(jié)論1、ACS患者中偏心性斑塊占多數(shù)且斑塊中NC比例高,SA斑塊中纖維組織及纖維脂肪組織占多數(shù);2、以下指標(biāo):(1)NC比例(2)斑塊偏心指數(shù)(3)血管重構(gòu)指數(shù)與血清脂蛋白相關(guān)磷脂酶A2、hs-CRP等指標(biāo)之間存在呈顯著正相關(guān)關(guān)系。3、血清脂蛋白相關(guān)磷脂酶A2對(duì)于判斷冠心病病人斑塊穩(wěn)定性方面具有較為可靠的預(yù)測作用。
[Abstract]:Objective to study imaging technique using intravascular ultrasound virtual organization (VH-IVUS) on patients with coronary heart disease and plaque analysis, clear plaque and serum lipoprotein associated phospholipase A2. (Lipoprotein-associated phospholipase A2.Lp-PLA2). The degree of correlation between the 1 methods, according to the total number of standard selection of patients with coronary heart disease was 115, stable angina pectoris (Stable Angina, SA) for 54 patients, acute coronary syndrome (Acute Coronary, Syndrome, ACS) patients accounted for 61, while the control group was 52, the diagnosis of.2, the target selection in the process of vascular contrast ultrasound, and record the inspection results and the gray-scale image for later the analysis and study of.3, obtained the research object of serum lipoprotein associated phospholipase A2 through detection, high sensitivity C- reactive protein (high sensitivity C-reactive protein). The level of.4 and other conventional blood indexes, through Statistical methods of serum lipoprotein associated phospholipase A2, high sensitive C- reactive protein and plaque composition were analyzed. Results 1 patients of the three groups in general, there was not statistical difference; 2 VH-IVUS results showed: ACS group of vascular remodeling index, necrotic core (necrotic core, NC), plaque eccentricity index were higher than that of group SA, the difference was statistically significant (P0.05), FF and fiber (fibrous tissue, FT plaque) ratio were lower than SA group, there was significant difference (P0.05) of 3 ACS patients serum lipoprotein associated phospholipase A2, hypersensitive C- reaction protein level was significantly higher than that of SA group and control group, the difference was statistically significant (P0.05) 4 ACS group, serum Lp-PLA2 level and plaque in the proportion of NC, vascular remodeling index and plaque index were positively related to eccentricity (r=0.736, P=0.016; r=0.651, P=0.024; r=0.719, P=0.027). Conclusion: 1, ACS in patients with eccentric plaque and plaque majority Block NC in high proportion, fibrous tissue and adipose tissue SA fiber plaque in the majority; 2, the following indicators: (1) the proportion of NC (2) plaque eccentricity index (3) vascular remodeling index and lipoprotein associated phospholipase A2, there was a significant positive correlation between.3 hs-CRP and other indicators, serum lipoprotein associated phospholipase A2 has forecast effect is reliable for judging the stability of plaque in patients with coronary heart disease.

【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.4

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