【作者】 彭民安；

【导师】 曹晶茗； 肖践明； 刘中梅；

【作者基本信息】 昆明医学院 ， 内科学， 2008， 硕士

【摘要】 【目的】:探讨内皮素(ET)与急性冠脉综合征(ACS)、易损斑块的发生发展及冠脉重构、狭窄程度的关系。【资料和方法】:对2007年1月至2008年4月间在昆明医学院第一附属医院住院的15例急性冠脉综合征(ACS)患者和15例稳定性心绞痛(SAP)患者行IVUS检查,对所检查的罪犯病变血管进行定性、定量检测,测量和计算靶血管的血管面积、管腔面积、斑块面积、斑块负荷、偏心指数及重构指数,识别出易损斑块,同时用放射免疫法检测两组患者血浆ET水平并进行比较分析。【结果】:1.ACS组和SAP组患者血浆ET水平均高于正常值,且两组患者血浆ET水平比较有显著性差异(P=0.001,P＜0.05),ACS组患者血浆ET水平明显高于SAP组患者。2.稳定性斑块组和易损斑块组患者血浆ET水平比较有显著性差异(P=0.001,P＜0.05),易损斑块组患者血浆ET水平明显高于稳定性斑块组患者。3.正性重构组与负性重构组患者比较有显著性差异(P=0.000,P＜0.05),正性重构组患者血浆ET水平明显高于负性重构组患者;正性重构组与无重构组患者比较无显著性差异(P=0.053,P＞0.05);无重构组与负性重构组患者比较无显著性差异(P=0.100,P＞0.05)。4.偏心斑块组患者和向心斑块组患者血浆ET水平比较有显著性差异(P=0.001,P＜0.05),偏心斑块组患者血浆ET水平明显高于向心斑块组患者血浆ET水平。5.不同组的冠脉病变支数及狭窄程度与血浆ET水平比较均无显著性差异(P＞0.05)。【结论】:1.ET水平在ACS患者中高于SAP患者和正常人。2.ET水平在易损斑块组患者中高于稳定斑块组患者。3.ET水平在正性重构组患者中高于负性重构组患者。4.ET水平与冠脉病变支数、狭窄程度可能无明显相关。更多还原

【Abstract】 [objective]: Discussion on the relationships between endothelin and the development of acute coronary syndrome(ACS)、vulnerable plaque, and then the relationships between endothelin and coronary remodeling、degree of coronary artery stenosis were also explored.[Material and Methods]: IVUS was used to examine the coronary lesions in15 cases of acute coronary syndrome (ACS) patients and 15 cases of stable angina pectoris (SAP) patients who remittal to the First Affiliated Hospital of Kunming Medical College from January 2007 to April 2008. We measured the coronary lesions with IVUS to evaluate quality and quantity respectivly in order to identify vulnerable plaque. And then the external elastic membrane area、lumen area、plaque area、and plaque load were all measured and calculated. And the eccentric index and remodeling index of the target vessel were also calculated. In the mean time, we also detected blood plasma ET levels by radioimmunoassay in the two groups of patients. Meanwhile, comparison analysis between them was performed.[Results]: (1). The ACS group patients and the SAP patients had higher blood plasma ET level than the normal, and the blood plasma ET levels in the ACS group patients were significantly higher than the SAP group patients(P<0.05). (2). Comparison on blood plasma ET levels between the stable plaque group and vulnerable plaque group, we found that the blood plasma ET levels in the vulnerable plaque group were significantly higher than the stable plaque group(P<0.05). (3). There were significant differences between the positive remodeling group and the negative remodeling group (P<0.05), the blood plasma ET levels in the positive remodeling group were significantly higher than the negative remodeling group. (4). The blood plasma ET levels in the eccentric plaque group patients were significantly higher than the endocentric plaque group. (5) .There were not any significant difference between the blood plasma ET levels and coronary lesions count and the different degree of stenosis.[Conclusion]: The blood plasma ET levels in the ACS group patients werehigher than the SAP group and the normal. Meanwhile, the blood plasma ET levels in the vulnerable plaque group patients were higher than the stable plaque group, and the positive remodeling group patients were higher than the negative remodeling group.更多还原