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中国临床药理学与治疗学 ›› 2004, Vol. 9 ›› Issue (6): 698-700.

• 研究原著 • 上一篇    下一篇

急性心肌梗死冠脉斑块形态特征的血管内超声研究

张航, 陈绍良, 单守杰, 叶飞, 周陵, 段宝祥, 刘玲玲, 阚静   

  1. 南京医科大学附属南京第一医院心内科, 南京210006, 江苏
  • 收稿日期:2003-09-27 修回日期:2003-12-12 发布日期:2020-11-22
  • 通讯作者: 张航,女, 住院医师, 研究方向:冠心病治疗。Tel:025-86624213-8298 E-mail:zhanghang@elong.com

Plaque morphological characteristics of acute myocardial infarction observed by intravascular ultrasound

ZHANG Hang, CHEN Shao-Liang, SHAN Shou-Jie, YE Fei, DUAN Bao-Xiang, ZHANG Jun-Jie   

  1. Department of Cardiology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, China
  • Received:2003-09-27 Revised:2003-12-12 Published:2020-11-22

摘要: 目的 通过应用血管内超声(IVUS) 对急性心肌梗死和稳定性心绞痛患者冠脉斑块的比较, 探讨急性心肌梗死患者梗死相关血管粥样斑块的形态特征。 方法 实验分2 组, 急性心肌梗死组:59 例急性心肌梗死患者, 男43 例, 女16 例, 平均年龄60 ±9岁;稳定性心绞痛组:50 例稳定性心绞痛患者, 男38例, 女12 例, 平均年龄62 ±10 岁。接受冠状动脉造影及血管内超声检查, 通过血管内超声评价斑块的偏心性、线状夹层、低回声血栓、无回声暗区及斑点状回声物质等形态特征。 结果 两组患者斑块偏心性及钙化无显著性差异, 但低回声血栓(急性心肌梗死组15 % vs 稳定性心绞痛组0 %), 线状夹层(37 %vs 4 %), 无回声暗区(31 %vs 0 %), 斑点状回声物质(90 %vs 0 %) 急性心肌梗死组较稳定性心绞痛组有显著性差异(P <0.01)。 结论 低回声血栓, 线状夹层, 无回声暗区, 斑点状回声物质为急性心肌梗死患者梗死相关血管斑块的形态特征, 可以证实斑块破裂与急性心肌梗死发生有关。

关键词: 急性心肌梗死, 血管内超声, 斑块特征, 斑块破裂

Abstract: AIM: To study the plaque morphological characteristics of acute myocardial infarction by intravascular ultrasound(IVUS), comparing plaque morphology in acute myocardial infarction and stable angina pectoris. METHODS: 59 patients with acute myocardial infarction (male 43, mean age 60 ±9 years) and 50 patients with stable angina pectoris (male 38, mean age 62 ±10 years) underwent coronary artery angiography (CAG) and IVUS examinations.The plaque morphology, including incidence of eccentric plaque, subtle dissections, low echoic thrombus, calcification, echolucent areas, and bright speckled echo material, were assessed by IVUS. RESULTS: There were no significant differences in plaque eccentricity or plaque calcification between the two groups, except low echoic thrombus(acute myocardial infarction 15 % vs stable angina pectoris 0 %), subtle dissection (37 % vs 4 %), echolucent areas (31 % vs 0 %), and bright speckled echo material (90 % vs 0 %) (P < 0.001 for all). CONCLUSION: Low echoic thrombus, subtle dissection, echolucent areas, and bright speckled echo material are morphological characteristics associated with plaque at the time of acute myocardial infarction.It is confirmed that the rupture of plaque is related to the occurrence of acute myocardial infarction.

Key words: acute myocardial infarction, intravascular ultrasound, plaque morphology, plaque rupture

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