心肌梗死与血管内超声档.docVIP

急性心肌梗死血管内超声特征及与Hs_CRP、 ProMMP_1和TIMP_1的关系【摘要】? 目的 研究急性心肌梗死（AMI）冠脉斑块的血管内超声（IVUS）特征，以及与高敏C反应蛋白（Hs_CRP）、基质金属蛋白酶_1前体（ProMMP_1）、基质金属蛋白酶_1抑制剂（TIMP_1）的关系。方法 冠脉介入治疗前应用IVUS研究22例AMI和68例稳定性心绞痛（SA）患者罪犯病变IVUS特征。应用ELISA方法检测血浆Hs_CRP、ProMMP_1和TIMP_1水平。结果 AMI全部表现为破裂斑块和不稳定斑块，而SA主要表现为稳定斑块；AMI组罪犯病变血管外弹力膜面积、斑块负荷、脂核负荷大于SA组，纤维帽更薄，正性重构、夹层和血栓多见。AMI组Hs_CRP、ProMMP_1和TIMP_1显著高于稳定斑块组，并与斑块破裂、血栓形成、夹层和纤维帽厚度具有显著相关性。结论 罪犯斑块性质和临床表现相关，AMI患者Hs_CRP、ProMMP_1和TIMP_1升高可能与斑块的不稳定性和破裂相关。 【关键词】? 冠状动脉疾病；超声检查，介入性；C反应蛋白；基质金属蛋白酶 ??? Intravascular Ultrasound Characteristics of Plaque in Acute Myocardial Infarction and the Relationship between IVUS and Hs_CRP、ProMMP_1、TIMP_1. YANG Jian_min, GAO Yan，ZHANG Xing_wei, et al. Department of Cardiology, Hangzhou First Peoples Hospital, Zhejiang 310006, China ??? ［Abstract］ Objective To explore the intravascular ultrasound(IVUS) characteristics of plaque in acute myocardial infarction(AMI), and to investigate the relationship between IVUS and hyper_sensitive C_reactive protein(Hs_CRP)、Pro_matrix metalloproteinase_1(ProMMP_1)、tissue inhibitors of matrix metalloproteinase_1(TIMP_1). Methods The culprit lesions were measured in 22 cases of AMI and 68 cases of SA by IVUS before coronary intervention. The plasma levels of Hs_CRP、ProMMP_1 and TIMP_1 were determined by ELISA. Results No stability plaque was discovered in AMI, which was mainly observed in SA. External elastic membrane cross_sectional area、plaque burden in AMI were significantly larger than those in SA. Positive remolding、 thinner fabric_cap、smaller minimal lumen cross_sectional area、dissection and thrombus were significantly more frequent in AMI. The levels of plasma Hs_CRP、ProMMP_1 and TIMP_1 were significantly higher in AMI than in SA. Hs_CRP、ProMMP_1 and TIMP_1 levels were correlated with plaque rupture、fabric_cap、dissection and thrombus. Conclusions The IVUS characteristics in AMI are different from those in SA. The elevation of Hs_CRP、ProMMP_1 and TIMP_1 in AMI may correlate with the plaque instability and r