关键词: 脂蛋白 (a), 虚拟组织学, 血管内超声, 易损斑块

Abstract:

Objective: To analyze the characteristics of atherosclerotic plaques in the patients with coronary heart disease (CHD)by virtual histology intravascular ultrasound (VH-IVUS),and to discuss their correlations with lipoprotein (a) ［Lp(a)］.Methods: 54 patients with chest pain were divided into non ST elevation acute coronary syndromes (NSTEACS)group (n=18),stable angina pectoris (SAP)group(n=21)and control group (n=15)according to the symptoms and coronary angiography results of the patients.The serum biochemical indexes were measured in all patients.In 39 CHD patients,culprit lesions were detected with VH-IVUS to investigate the characteristics of atherosclerotic plaques and their relevance with Lp(a). Results:The levels of Lp(a),low density lipoprotein (LDL)and hypersensitive C reactive protein (hs-CRP)of the patients in NSTEACS and SAP groups were significantly higher than those in control group (P< 0.05);the levels of serum Lp(a),hs-CRP and LDL in NSTEACS group were higher than those in SAP group(P<0.05).The incidence of necrotic tissue (NC),fiber lipid (FF),and vulnerable plaque (TCFA)in lesion patches of the patients in SAP group were significantly decreased(P<0.05)compared with NSTEACS group.The plasma Lp(a) was positively associated with NC,FF,TCFA serum and hs-CRP (r =0.411,r =0.312,r =0.318,r =0.309,P<0.05).Conclusion: The vulnerability of plaques in the NSTEACS patients in creases with the increase of Lp(a) level:Plasma Lp(a) is a sensitive index for evaluating the plaque vulnerability.

Key words: lipoprotein (a), virtual histology, intravascular ultrasound, vulnerable plaques