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目的探讨老年急性冠状动脉综合征(ACS)的衰减斑块(AP)特点。方法选择符合条件的166例ACS患者,分为老年组92例和非老年组74例,记录一般临床资料、冠状动脉造影血管病变情况和罪犯斑块的血管内超声特点,主要包括有无AP、最大衰减回声弧度、血管外弹力膜面积、管腔面积、斑块面积,计算斑块负荷和重构指数。结果与非老年组比较,老年组3支冠状动脉病变的比例较高(50.0%vs 35.1%,P=0.038),AP更多(62.0%vs45.9%,P=0.039),最大衰减回声弧度[(142±80)°vs(115±54)°,P=0.000]、斑块面积[(14.2±3.9)mm2 vs(12.3±4.1)mm2,P=0.022]、斑块负荷[(81.1±14.2)%vs(76.4±13.5)%,P=0.042]和重构指数[(1.2±0.2)vs(1.1±0.1),P=0.031]更高。结论老年ACS患者的发病与不稳定斑块的关系更为密切,加强稳定斑块的治疗措施,将有助于老年ACS的防治。
Objective To investigate the characteristics of attenuated plaque (AP) in elderly patients with acute coronary syndrome (ACS). Methods A total of 166 ACS patients were selected and divided into 92 elderly patients and 74 non-elderly patients. The general clinical data, Maximum attenuation echo radian, extravascular elastic membrane area, lumen area, plaque area, plaque load and reconstruction index. Results Compared with the non-elderly group, the proportion of coronary artery lesions in 3 elderly patients was higher (50.0% vs 35.1%, P = 0.038), AP more (62.0% vs 45.9%, P = 0.039) [(142 ± 80) ° vs (115 ± 54) °, P = 0.000], plaque area [(14.2 ± 3.9) mm2 vs (12.3 ± 4.1) mm2, P = 0.022) 14.2)% vs (76.4 ± 13.5)%, P = 0.042 and reconstitution index [(1.2 ± 0.2) vs (1.1 ± 0.1), P = 0.031]. Conclusion The incidence of ACS in elderly patients is more closely related to unstable plaque. Strengthening the treatment of stable plaque will be helpful for the prevention and treatment of elderly ACS.