本文選題：冠狀動脈疾病 + 血小板源性生長因子�。� 參考：《中國循環(huán)雜志》2017年06期

【摘要】：目的:采用血管內超聲(IVUS)技術檢測不同類型冠心病患者冠狀動脈內粥樣硬化斑塊的性質及其與血清血小板源性生長因子(PDGF)的關系研究。方法:選取2011-01至2013-10期間勝利油田中心醫(yī)院住院并行冠狀動脈造影檢查的患者106例作為研究對象,其中急性冠狀動脈綜合征患者(ACS組)60例,穩(wěn)定性心絞痛患者(SAP組)46例。記錄患者性別、年齡、吸煙史、高血壓病史、糖尿病病史等基本資料,采用雙抗體夾心酶聯免疫吸附法(ELISA法)檢測患者血清PDGF水平。同時對兩組患者進行IVUS檢查,詳細記錄罪犯血管最狹窄處冠狀動脈粥樣斑塊形態(tài)、性質、斑塊破裂、血栓形成、重構情況以及病變處外彈力膜面積、管腔面積、斑塊面積、偏心指數等。比較兩組斑塊性質、斑塊破裂和血栓形成發(fā)生率、正性重構比率以及外彈力膜面積、偏心指數等的差異,以及不同斑塊性質血清PDGF水平的差異。結果:(1)SAP組血清PDGF濃度為(3.64±0.60)ng/L顯著高于ACS組(2.12±0.51)ng/L,兩組比較差異有統(tǒng)計學意義(P0.05)。(2)SAP組患者冠狀動脈病變以硬斑塊為主,ACS組患者斑塊以軟斑塊為主。與SAP組比較,ACS組患者斑塊破裂、血栓形成、正性重構發(fā)生率高,且ACS組較SAP組斑塊以偏心斑塊為主,偏心指數低,差異均有統(tǒng)計學意義(P0.05~0.01)。與SAP組比較,ACS組患者病變血管外彈力膜面積較大,差異有統(tǒng)計學差異(P0.01)。(3)纖維斑塊、鈣化斑塊、混合斑塊(硬斑塊)血清PDGF水平均低于軟斑塊,差異有統(tǒng)計學意義(P0.05~0.01)。結論:PDGF參與冠狀動脈粥樣硬化斑塊的形成,在ACS的發(fā)病中起著重要作用,斑塊越不穩(wěn)定,PDGF的濃度越高,檢測血清PDGF水平有助于診斷和預測ACS的發(fā)生,使ACS的診斷流程和治療策略的選擇更趨于合理和規(guī)范。
[Abstract]:Objective: to study the relationship between the characteristics of coronary atherosclerotic plaque and serum platelet derived growth factor (PDGF) in patients with coronary artery disease (CHD) by intravascular ultrasound (IVUSS). Methods: 106 patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP) in Shengli Oilfield Central Hospital underwent coronary angiography from January 2011 to October 2013-10 were selected as the study subjects, including 60 patients with acute coronary syndrome (ACS) and 46 patients with stable angina pectoris (SAP). Sex, age, smoking history, hypertension history, diabetes history and other basic data were recorded. The serum PDGF level was detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). At the same time, two groups of patients were examined by IVUS. The morphology, nature, plaque rupture, thrombus formation, remodeling and the area of external elastic membrane, lumen and plaque of coronary atherosclerotic plaque were recorded in detail. Eccentricity index, etc. The characteristics of plaque, the incidence of plaque rupture and thrombosis, the ratio of positive remodeling, the area of outer elastic membrane and eccentricity index, and the difference of serum PDGF level between the two groups were compared. Results the serum PDGF concentration in the SAP group was 3.64 鹵0.60)ng/L significantly higher than that in the ACS group (2.12 鹵0.51ng / L). The difference between the two groups was statistically significant (P 0.05). Compared with SAP group, the incidence of plaque rupture, thrombosis and positive remodeling in ACS group was higher than that in SAP group, and the eccentricity index was lower in ACS group than in SAP group. Compared with the SAP group, the area of the diseased extravascular elastic membrane in the SAP group was larger than that in the control group, and the difference was statistically significant (P 0.01). The levels of serum PDGF in calcified plaques and mixed plaques (hard plaques) were lower than those in the soft plaques (P 0.05 0. 01), and the difference was statistically significant (P 0. 05 0. 01). Conclusion the presence of ACS in coronary atherosclerotic plaque may play an important role in the pathogenesis of ACS. The higher the concentration of PDGF in plaque is, the higher the concentration of PDGF is. The detection of serum PDGF level is helpful to diagnose and predict the occurrence of ACS. The diagnosis process and treatment strategy of ACS are more reasonable and standardized.
【作者單位】： 勝利油田中心醫(yī)院內科;
【基金】：山東省醫(yī)藥衛(wèi)生科技發(fā)展計劃項目(2011HW075)
【分類號】：R541.4

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