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目的:探讨微囊泡与冠状动脉不稳定粥样硬化斑块之间的关系。方法:选取2013-12-2015-09因胸痛、胸闷等症状在天津市胸科医院就诊并住院的患者共471例,分别为急性冠状动脉综合征患者(ACS组)245例、稳定型心绞痛患者(SA组)103例和冠状动脉正常人(对照组)123例。检测入选研究对象的血浆微囊泡水平,比较ACS组、SA组和对照组之间血浆微囊泡浓度的差异。使用非条件Logistic回归分析冠状动脉斑块不稳定性的影响因素。应用ROC曲线评价微囊泡对不稳定性斑块的预测价值。结果:ACS组患者血浆微囊泡水平明显高于SA组和对照组(P<0.01),SA组与对照组相比无显著性差异(P>0.05),AMI组与UA组相比无显著性差异(P>0.05)。多因素回归分析显示,脂蛋白(a)[LP(a)]、C反应蛋白(CRP)和微囊泡均为不稳定性斑块的独立影响因素。ROC曲线分析显示微囊泡诊断不稳定性斑块的曲线下面积(AUC)为0.74。结论:微囊泡与冠状动脉不稳定粥样硬化斑块密切相关,可作为评价冠状动脉不稳定粥样硬化斑块的生化指标。
Objective: To investigate the relationship between microvesicles and unstable atherosclerotic plaque in coronary artery. Methods: A total of 471 patients were selected from Tianjin Chest Hospital for chest pain, chest tightness and other symptoms during 2013-12-2015-09. Among them, there were 245 patients with acute coronary syndrome (ACS group), 245 patients with stable angina pectoris (SA group) 103 cases and normal coronary artery (control group) 123 cases. The level of plasma microvesicles in the study subjects was measured, and the difference of plasma microvesicle concentration between ACS group, SA group and control group was compared. Factors influencing plaque instability of coronary artery using non - conditional Logistic regression. Evaluation of the predictive value of microvesicles on unstable plaque by ROC curve. Results: The levels of plasma microvesicles in ACS group were significantly higher than those in SA group and control group (P <0.01), but there was no significant difference between SA group and control group (P> 0.05). There was no significant difference between AMI group and UA group Sex differences (P> 0.05). Multivariate regression analysis showed that lipoprotein (a) [LP (a)], C-reactive protein (CRP) and microvesicle were all independent factors of unstable plaque. ROC curve analysis showed that the area under the curve (AUC) of microvesicles for the diagnosis of unstable plaques was 0.74. Conclusion: The microvessels are closely related to unstable atherosclerotic plaques of coronary artery and can be used as a biochemical marker to evaluate unstable atherosclerotic plaques in coronary artery.