CAJ | 학술논문

目的：应用虚拟组织学-血管内超声（ virtual histology intravascular ultrasound，VH-IVUS）分析不稳定型心绞痛（ unstable angina，UA）患者冠脉斑块的特点，探讨斑块结构与血脂水平的相关性。方法选取UA患者41例，结合冠脉造影、血管内超声检查发现斑块破裂等，综合确定罪犯病变。对比最小管腔面积（ MLA）处斑块各成分面积绝对值及相对值、整个斑块成分体积绝对值及相对值与血脂水平的相关性。结果 MLA处，坏死核心（ NC ）的面积百分比与血脂各项均无明显相关。NC面积绝对值与TG呈正相关（P＜0.01），与HDL-C呈负相关（P＜0.05）。在整个斑块节段中，NC体积相对值与TC、LDL-C及LDL／HDL呈正相关（均P＜0.05）。但斑块各成分的绝对体积与血脂各项均无相关性。结论 TC、LDL-C及LDL-C／HDL-C与斑块的组成，尤其是斑块NC区的体积百分比相关，有望成为辅助冠心病斑块成分分析的无创性检查。
목적：응용허의조직학-혈관내초성（ virtual histology intravascular ultrasound，VH-IVUS）분석불은정형심교통（ unstable angina，UA）환자관맥반괴적특점，탐토반괴결구여혈지수평적상관성。방법선취UA환자41례，결합관맥조영、혈관내초성검사발현반괴파렬등，종합학정죄범병변。대비최소관강면적（ MLA）처반괴각성분면적절대치급상대치、정개반괴성분체적절대치급상대치여혈지수평적상관성。결과 MLA처，배사핵심（ NC ）적면적백분비여혈지각항균무명현상관。NC면적절대치여TG정정상관（P＜0.01），여HDL-C정부상관（P＜0.05）。재정개반괴절단중，NC체적상대치여TC、LDL-C급LDL／HDL정정상관（균P＜0.05）。단반괴각성분적절대체적여혈지각항균무상관성。결론 TC、LDL-C급LDL-C／HDL-C여반괴적조성，우기시반괴NC구적체적백분비상관，유망성위보조관심병반괴성분분석적무창성검사。
Objective We used virtual histology intravascular ultrasound to evaluate the relationship between blood lipids and plaque composition in patients with unstable angina( UA) .Methods Forty-one UA patients were included in our study.Culprit lesion were identified by analyzing ST-T alternation on electrocardiograms,left ventricular wall motion abnormalities,angiographic complex le-sions and IVUS-detected plaque rupture.We performed VH-IVUS examination on each culprit lesion and analyzed the relationship be-tween blood lipids and VH-IVUS characters of the culprit lesions.Results At the minimal lumen area site,percent of necrotic core ar-ea and blood fat had no correlation.The area of necrotic core was positively associated with triglyceride(P<0.01),and negatively as-sociated with HDL-C ( P <0.05 ) .Necrotic core component was positively associated with triglyceride, LDL-C and LDL/HDL ( P <0.05).No significant correlations were observed between blood fat and the composition of plaque in patients with UA.Conclusion Cholesterol,LDL-C and the ratio of LDL-C/HDL-C are all associated with the component of necrotic core,which can influence theplaque vulnerability.Therefore,blood lipids can be used as predictor of the severity of the coronary artery disease.