冠状动脉粥样硬化易损斑块与单核细胞趋化活性的相关性研究

山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (5): 98-.

冠状动脉粥样硬化易损斑块与单核细胞趋化活性的相关性研究

齐天军1,2,陈文强1,姜翠玲2,杨天豪3,翟梅青2,李大庆1,由倍安1,李继福1

1. 山东大学齐鲁医院心内科，济南 250012； 2.山东省淄博矿业集团有限责任公司中心医院心内科，山东淄博 255120； 3.河北联合大学研究生院，河北唐山 063000

收稿日期:2010-12-27 出版日期:2011-05-10 发布日期:2011-05-10
通讯作者: 李继福（1962- ），男，主任医师，教授,主要从事心血管介入治疗。 E-mail：jifuli1028@Yahoo.com.cn
作者简介:齐天军（1972- ），男，硕士研究生，副主任医师,主要从事心血管介入治疗。 E-mail：qtjzmq@sina.com
基金资助:
国家自然科学基金资助项目（30871040，30971216）；山东省自然科学基金资助项目(Y2008C17)。

A correlation study of monocyte chemotaxis and IVUS features of atherosclerotic plaques in the patients with angina pectoris

QI Tian-jun1,2, CHEN Wen-qiang1, JIANG Cui-ling2, YANG Tian-hao3, ZHAI Mei-qing2, Li Da-qing1, YOU Bei-an1， LI Ji-fu1

1. Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, China;
2. Department of Cardiology, the Affiliated Hospital of Zibo coal Berual, Zibo 255120, Shandong, China;
3. Graduate School of Hebei United University, Tangshan 063000, Hebei, China

Received:2010-12-27 Online:2011-05-10 Published:2011-05-10

摘要/Abstract

摘要：

目的利用血管内超声（IVUS）探讨冠状动脉易损斑块与血中单核细胞趋化活性的相关性。方法对40例稳定型心绞痛(SAP)和40例不稳定型心绞痛(UAP)患者分别进行冠脉造影（CAG）和血管内超声（IVUS）检查。应用IVUS分别观察比较冠状动脉内斑块的性质，同时测量冠脉病变部位及其参考部位的血管外弹力膜面积（EEMA）、管腔面积（LA）、斑块面积（PA）及斑块负荷（PB%），并计算斑块的偏心指数（EI）及血管的重构指数（RI）。应用Transwell小室检测两组患者血液中单核细胞的趋化活性。相关性分析IVUS检测指标与单核细胞活性的相关性。结果IVUS检测显示，UAP组主要为脂质性斑块，约占50%（46/92），而SAP组主要为纤维性斑块，约占55%（46/83），脂质斑块仅占17% (14/83)。与SAP组比较，UAP组斑块负荷和血管重构指数显著增高（P均<0.01）。与SAP组的斑块相比较，UAP组的斑块具有较大的偏心性（P<0.05），不稳定斑块呈明显的正性重构，约占68 % （27/40），而稳定斑块主要表现为负性重构，约占75％（30/40）。UAP组单核细胞趋化活性明显增强，单核细胞移动数量明显多于SAP组，差异有统计学意义（P<0.01）。相关性分析显示，IVUS测值PB与单核细胞趋化活性呈显著正相关（γ=0.52，P<0.01）。结论 IVUS能够准确地识别AS易损斑块。单核细胞趋化活性反映了粥样斑块的稳定性。

关键词: 动脉硬化；易损斑块；趋化活性；血管内超声

Abstract:

Objective To study the correlation between characteristics of unstable atherosclerotic plaques with intravascular ultrasound (IVUS) and monocyte chemotaxis. Methods Forty patients with stable angina pectoris (SAP) and forty patients with unstable angina pectoris (UAP) were enrolled into the study. Coronary arteriography (CAG) and IVUS were performed in all patients. IVUS was used to analyze the qualities of the plaques and measure the external elastic membrane (EEM) area, lumen area（LA）, plaque area（PA）and plaque burden (PB%) at both the lesion and the reference segments in the same vessel. The lumen eccentricity index （EI）and remodeling index(RI) were calculated. Peripheral monocyte chemotaxis was assayed by the transwell chamber. Results Soft lipid plaques were foundin 50% of patients with unstable angina , while the patients with stable angina mainly suffered from fibrous and mixed plaques(55%), and only 17 % soft plaques. There were more eccentric plaques in the unstable than the stable groups(P<0.05), and EEMA, LA, PA and PB in the unstable plaques were larger than those of stable plaques (all P<0.01). A positive remodeling pattern was identified in 68% (27/40) unstable plaques while 75%(30/40) stable plaques showed negative remodeling. The average number of migrated monocytes measured in UAP patients were more than that in patients with SAP(P<0.01). The UAP group showed a higher activity of monocyte chemotaxis ability. PB measured with IVUS correlated well with monocytes chemotaxis(γ=0.52，P<0.01). Conclusions IVUS can detect unstable atherosclerotic plaques and predict plaque disruption in the early stage of atherosclerosis. Monocyte chemotaxis ability is associated with the stability of atherosclerotic plaques.

Key words: Intravascular ultrasound; Arteriosclerosis; Vulnerable plaque; Chemotaxis

中图分类号:

R543.5

齐天军1,2,陈文强1,姜翠玲2,杨天豪3,翟梅青2,李大庆1,由倍安1,李继福1. 冠状动脉粥样硬化易损斑块与单核细胞趋化活性的相关性研究[J]. 山东大学学报(医学版), 2011, 49(5): 98-.

QI Tian-jun1,2, CHEN Wen-qiang1, JIANG Cui-ling2, YANG Tian-hao3, ZHAI Mei-qing2, Li Da-qing1, YOU Bei-an1， LI Ji-fu1. A correlation study of monocyte chemotaxis and IVUS features of atherosclerotic plaques in the patients with angina pectoris[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(5): 98-.

参考文献

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed

[1]	邢姗姗1，巩祖顺2，穆伟2，王东3，宫玉玲4，邢启崇2. 活体人主动脉组织高迁移率族蛋白B1的表达及其与动脉粥样硬化发病机制的关系[J]. 山东大学学报(医学版), 2013, 51(10): 62-65.
[2]	张弘1，姜海军1，杨植1，张小明2. 急性下肢缺血67例诊治分析[J]. 山东大学学报(医学版), 2012, 50(3): 87-89.
[3]	邢启崇. 心肌梗死量对性行为影响的临床研究[J]. 山东大学学报(医学版), 2011, 49(10): 73-76.
[4]	邢姗姗1，张伟2，邢启崇3. 心肌梗死后性行为危险因素的临床研究[J]. 山东大学学报(医学版), 2010, 48(9): 72-75.
[5]	宫玉玲1，2，邢姗姗3，张伟4，邢启崇1，2. Toll样受体4与动脉粥样硬化的关系[J]. 山东大学学报(医学版), 2010, 48(3): 127-130.