| 徐华,陈东风,王少春,马洪振,李清贤,王彦富.颈动脉内中膜厚度结合血清MMP-9及APN预测冠状动脉斑块稳定性[J].中国医学影像技术,2015,31(1):47~51 |
| 颈动脉内中膜厚度结合血清MMP-9及APN预测冠状动脉斑块稳定性 |
| Carotid intima-media thickness combined with matrix metalloproteinase-9 and Adiponectin in diagnosis of coronary plaque stability |
| 投稿时间：2014-07-29 修订日期：2014-09-16 |
| DOI：10.13929/j.1003-3289.2015.01.013 |
| 中文关键词: 体层摄影术,光学相干 基质金属蛋白酶-9 脂联素 颈动脉 冠状血管 斑块,动脉粥样硬化 |
| 英文关键词:Tomography, opitical coherence Matrix metalloproteinase-9 Adiponectin Carotid arteries Coronary vessel Plaque, atherosclerotic |
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| 中文摘要: |
| 目的 探讨颈动脉内-中膜厚度(CIMT)、血清脂联素(APN)、血清基质金属蛋白酶-9(MMP-9)诊断冠状动脉不稳定斑块的价值。方法 选取接受OCT检查的急性冠状动脉综合征(ACS)患者27例(ACS组),并选取同期来诊的急性胸闷、胸痛而冠状动脉造影阴性者30例为对照组。检测血清APN及MMP-9,并行颈动脉超声检查,并记录CIMT、APN、MMP-9和冠状动脉斑块纤维帽厚度;分析两组指标的差异及各指标之间的相关性,绘制ROC曲线评价各指标对薄纤维帽斑块的诊断价值。结果 ACS患者CIMT、MMP-9水平显著高于正常组(P<0.01),而APN水平显著低于正常组(P<0.01);冠状动脉斑块纤维帽厚度与CIMT及MMP-9呈负相关(r=-0.357,P<0.05;r=-0.477,P<0.01),与APN呈正相关(r=0.468,P<0.05);CIMT、MMP-9、APN联合检测诊断冠状动脉薄纤维帽斑块的ROC曲线下面积大于单个指标的曲线下面积(分别为:0.815、0.688、0.772、0.739)。结论 CIMT值及MMP-9水平升高、APN水平降低与冠状动脉斑块的稳定性密切相关,且三者联合对ACS更具诊断价值。 |
| 英文摘要: |
| Objective To study the value of carotid intima-media thickness (CIMT), matrix metalloproteinase-9 (MMP-9) and Adiponectin (APN) in diagnosis of coronary unstable plaques. Methods Twenty-seven patients with acute coronary syndrome (ACS) examined with optical coherence tomography (OCT; ACS group), and thirty patients with acute chest pain and with negative coronary angiography as control group were enrolled. The serum levels of MMP-9 and the serum levels of APN were measured, and the carotid ultrasound was performed on all subjects. The CIMT, the levels of MMP-9, the levels of APN, the thickness of the fibrous cap in coronary plaques were recorded and compared, ROC were drawn to evaluate the diagnostic value of thin fibrous cap plaque (TFCA). Results Compared with the control group, the serum MMP-9 and CIMT were significantly higher while the serum adiponectin was significantly lower in ACS group (all P<0.01). There was negative correlation between fibrous cap thickness of coronary plaques and serum levels of MMP-9 and CIMT (r=-0.357, all P<0.05; r=-0.477, P<0.01), positive correlation between fibrous cap thickness and serum levels of APN (r=0.468, P<0.05). The area under the ROC curve of CIMT, MMP-9, APN in diagnosis of TFCA were 0.688, 0.772, 0.739, prospectively, and 0.815, combined. Conclusion The CIMT and serum levels of MMP-9 increasing and the serum levels of APN decreasing have strong correlation with coronary plaque stability. And combined with CIMT, MMP-9 and APN have a high diagnostic value of ACS. |
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