【摘要】：目的探討頸動(dòng)脈內(nèi)-中膜厚度(CIMT)、血清脂聯(lián)素(APN)、血清基質(zhì)金屬蛋白酶-9(MMP-9)診斷冠狀動(dòng)脈不穩(wěn)定斑塊的價(jià)值。方法選取接受OCT檢查的急性冠狀動(dòng)脈綜合征(ACS)患者27例(ACS組),并選取同期來(lái)診的急性胸悶、胸痛而冠狀動(dòng)脈造影陰性者30例為對(duì)照組。檢測(cè)血清APN及MMP-9,并行頸動(dòng)脈超聲檢查,并記錄CIMT、APN、MMP-9和冠狀動(dòng)脈斑塊纖維帽厚度;分析兩組指標(biāo)的差異及各指標(biāo)之間的相關(guān)性,繪制ROC曲線評(píng)價(jià)各指標(biāo)對(duì)薄纖維帽斑塊的診斷價(jià)值。結(jié)果 ACS患者CIMT、MMP-9水平顯著高于正常組(P0.01),而APN水平顯著低于正常組(P0.01);冠狀動(dòng)脈斑塊纖維帽厚度與CIMT及MMP-9呈負(fù)相關(guān)(r=-0.357,P0.05;r=-0.477,P0.01),與APN呈正相關(guān)(r=0.468,P0.05);CIMT、MMP-9、APN聯(lián)合檢測(cè)診斷冠狀動(dòng)脈薄纖維帽斑塊的ROC曲線下面積大于單個(gè)指標(biāo)的曲線下面積(分別為:0.815、0.688、0.772、0.739)。結(jié)論 CIMT值及MMP-9水平升高、APN水平降低與冠狀動(dòng)脈斑塊的穩(wěn)定性密切相關(guān),且三者聯(lián)合對(duì)ACS更具診斷價(jià)值。
[Abstract]:Objective to evaluate the value of carotid intima-media thickness (CIMT), serum adiponectin (APN), serum matrix metalloprotease-9 (MMP-9) in the diagnosis of coronary artery unstable plaques. Methods 27 patients with acute coronary syndrome (ACS) group) underwent OCT examination (ACS group), and 30 patients with acute chest tightness, chest pain and negative coronary angiography were selected as control group. Serum APN and MMP-9, were detected by carotid ultrasound, and the thickness of CIMT,APN,MMP-9 and coronary artery plaque fiber cap was recorded. The difference between the two groups of indexes and the correlation between them were analyzed, and the ROC curve was drawn to evaluate the diagnostic value of each index in thin fiber cap plaques. Results the level of CIMT,MMP-9 in patients with ACS was significantly higher than that in normal group (P 0.01), while the level of APN was significantly lower than that in normal group (P 0.01). There was a negative correlation between the thickness of coronary artery plaque cap and CIMT and MMP-9 (r 鈮，

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