中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
5期
422-425
,共4页
陈步星%马风云%罗维%阮剑洪%赵希哲%谢文丽%孙淑红%郭旭梅%王枫%田婷%褚晓雯
陳步星%馬風雲%囉維%阮劍洪%趙希哲%謝文麗%孫淑紅%郭旭梅%王楓%田婷%褚曉雯
진보성%마풍운%라유%원검홍%조희철%사문려%손숙홍%곽욱매%왕풍%전정%저효문
冠状动脉疾病%体层摄影术,光学%斑块
冠狀動脈疾病%體層攝影術,光學%斑塊
관상동맥질병%체층섭영술,광학%반괴
Coronary disease%Tomography,optics%Plaque
目的 应用光学相干断层成像(OCT)技术比较不稳定性心绞痛(UAP)和稳定性心绞痛(SAP)患者冠状动脉粥样硬化斑块特征.方法 对临床诊断的23例UAP和24例SAP患者,在完成冠状动脉造影并确诊冠心病后进行OCT检查.根据OCT结果 回顾性比较分析UAP和SAP患者冠状动脉粥样硬化斑块特征,包括富含脂质斑块(≥2个象限的脂质斑块)、斑块纤维帽厚度、薄纤维帽粥样斑块(TCFA)、斑块破裂、钙化和血栓等.结果 47例患者中有44例成功进行OCT检查,包括22例UAP和22例SAP患者.UAP患者冠状动脉富含脂质斑块为91%(20/22),多于SAP患者的73%(16/22),但差异无统计学意义(P=0.741).UAP患者冠状动脉脂质斑块表面纤维帽厚度明显小于SAP患者[(69.5±34.7)μm比(141.1±68.5)μm,P=0.000],纤维帽侵蚀比例为59%(13/22),明显多于SAP患者的9%(2/22,P=0.000);TCFA[73%(16/22)比14%(3/22),P=0.000]和斑块破裂[50%(11/22)比9%(2/22),P=0.003]多于SAP患者.UAP患者冠状动脉斑块表而可见血栓形成多于SAP患者,但差异无统计学意义[27%(6/22)比9%(2/22),P=0.761].在斑块钙化方面,UAP与SAP患者之间差异无统计学意义.结论 OCT技术可清晰显示冠状动脉粥样斑块特征.与SAP患者比较,UAP患者冠状动脉粥样硬化斑块表现为纤维帽更薄、更多的纤维帽侵蚀、更多的破裂斑块和TCFA.
目的 應用光學相榦斷層成像(OCT)技術比較不穩定性心絞痛(UAP)和穩定性心絞痛(SAP)患者冠狀動脈粥樣硬化斑塊特徵.方法 對臨床診斷的23例UAP和24例SAP患者,在完成冠狀動脈造影併確診冠心病後進行OCT檢查.根據OCT結果 迴顧性比較分析UAP和SAP患者冠狀動脈粥樣硬化斑塊特徵,包括富含脂質斑塊(≥2箇象限的脂質斑塊)、斑塊纖維帽厚度、薄纖維帽粥樣斑塊(TCFA)、斑塊破裂、鈣化和血栓等.結果 47例患者中有44例成功進行OCT檢查,包括22例UAP和22例SAP患者.UAP患者冠狀動脈富含脂質斑塊為91%(20/22),多于SAP患者的73%(16/22),但差異無統計學意義(P=0.741).UAP患者冠狀動脈脂質斑塊錶麵纖維帽厚度明顯小于SAP患者[(69.5±34.7)μm比(141.1±68.5)μm,P=0.000],纖維帽侵蝕比例為59%(13/22),明顯多于SAP患者的9%(2/22,P=0.000);TCFA[73%(16/22)比14%(3/22),P=0.000]和斑塊破裂[50%(11/22)比9%(2/22),P=0.003]多于SAP患者.UAP患者冠狀動脈斑塊錶而可見血栓形成多于SAP患者,但差異無統計學意義[27%(6/22)比9%(2/22),P=0.761].在斑塊鈣化方麵,UAP與SAP患者之間差異無統計學意義.結論 OCT技術可清晰顯示冠狀動脈粥樣斑塊特徵.與SAP患者比較,UAP患者冠狀動脈粥樣硬化斑塊錶現為纖維帽更薄、更多的纖維帽侵蝕、更多的破裂斑塊和TCFA.
목적 응용광학상간단층성상(OCT)기술비교불은정성심교통(UAP)화은정성심교통(SAP)환자관상동맥죽양경화반괴특정.방법 대림상진단적23례UAP화24례SAP환자,재완성관상동맥조영병학진관심병후진행OCT검사.근거OCT결과 회고성비교분석UAP화SAP환자관상동맥죽양경화반괴특정,포괄부함지질반괴(≥2개상한적지질반괴)、반괴섬유모후도、박섬유모죽양반괴(TCFA)、반괴파렬、개화화혈전등.결과 47례환자중유44례성공진행OCT검사,포괄22례UAP화22례SAP환자.UAP환자관상동맥부함지질반괴위91%(20/22),다우SAP환자적73%(16/22),단차이무통계학의의(P=0.741).UAP환자관상동맥지질반괴표면섬유모후도명현소우SAP환자[(69.5±34.7)μm비(141.1±68.5)μm,P=0.000],섬유모침식비례위59%(13/22),명현다우SAP환자적9%(2/22,P=0.000);TCFA[73%(16/22)비14%(3/22),P=0.000]화반괴파렬[50%(11/22)비9%(2/22),P=0.003]다우SAP환자.UAP환자관상동맥반괴표이가견혈전형성다우SAP환자,단차이무통계학의의[27%(6/22)비9%(2/22),P=0.761].재반괴개화방면,UAP여SAP환자지간차이무통계학의의.결론 OCT기술가청석현시관상동맥죽양반괴특정.여SAP환자비교,UAP환자관상동맥죽양경화반괴표현위섬유모경박、경다적섬유모침식、경다적파렬반괴화TCFA.
Objective To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT). Methods OCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by ≥ 2 quandrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients. Results OCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs, 73% (16/22),P =0. 741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5±34.7) μm vs. (141.1±68.5) μm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P=0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22) ,P = 0.000] and plaque rupture [50% (11/22) vs.9% (2/22) , P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups. Conclusions OCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.
