| Objective : Non-invasive distinguish of unstability plaque of coronary artery lesions by multislice spiral computed tomography (MSCT) tomography is a new break through in Medical imaging .High sensitivity C-reactive proteins (Hs-CRP) is a special efficacy inflammation index in risk stratification and prognostic evaluate in patients with coronary heart disease (CHD). In the study, Serum levels of Hs-CRP and homocystein (Hcy) were measured in 60 patients with CHD whose coronary artery different quality plaque were showed by 16-slice spiral computed tomography (16-CT) angiography. We evaluate the distinguish value of plaque stability of coronary artery lesions by combining 16-CT angiography with serum Hs-CRP measurement in clinical . Methods : In the Study, 96 patients were enrolled form February 2004 to December 2004 in hospital, including 55 men and 5 women, average age (58±4)years. All patients have been excepted acute and chronic infection. First, according to the clinical diagnose they were divided into Three groups : normol group(36 cases), acute coronary syndrome group (ACS) (36 cases) and stable angina pectories group (SAP) (24 cases); (all were tested by coronary angiography) Second, all patients underwent 16-CT angiography to distinguish the quality of plaque of coronary artery lesions before CAG. According to the CT scale, these patients were divided into three groups: normol group(36 cases), soft plaque group (24 cases ), mix plaque group (14 cases ) and hard plaque group (22 cases). Blood samples were taken to measure levels of serum Hs-CRP and Hcy before angiography in all patients. Result : (1) The combining ratios of the main traditional risk factors causing CHD such as age ,Sex ,family history of early coronary heart disease, smoking history, hypertension , diabetes mellitus; hyperlipidemia and so on (all the faetors above may have effect on the level of Hs-CRP ) in every group above have no obvious statistical difference (P>0.05). (2) The comparison of distribution of different quality plaque between ACS group and SAP group :Distributing of soft plaque and mix plaque in ACS group was significantly higher than that in SAP group (p<0.05), Distributing of hard plaque in SAP group was significantly higher than that in ACS group (P<0.05); (3) The comparison of the levels of serum Hs-CRP and Hcy among plaque groups: Mean levels of serum Hs-CRP and Hcy in three plaque groups was obvious higher than that in normol group (P<0.01),Mean levels of serum Hs-CRP and Hcy in soft plaque group and mix plaque group was obvious higher than that in hard plaque group (P<0.001), but there is no statistical difference between soft plaque group and mix plaque group (P<0.05); (4) The comparison of the levels of serum Hs-CRP and Hcy among three clinical groups : Mean serum Hs-CRP and Hcy levels ACS group and SAP group was significantly higher than that in normol group (P<0.01),Mean serum Hs-CRP and Hcy levels in ACS group was significantly higher than that in SAP group (P<0.05). Conculsion: (1) 16-CT may a accuracy noninvasive way to distinguish different quality plaque of coronary artery lesions; (2) serum Hs-CRP level can be considered as one of the indexes to judge the degree of CHD and may reflect the activities of plaque in CHD patient; (3) Furthermore, combining 16-CT angiography with serum level of Hs-CRP could contribute preferably to distinguishing plaque stability of coronary lesions in clinic, it is important for clinical diagnosis and risk evaluation of CHD patient. objective: Coronary angiography is the standard of reference in the diagnosis of coronary artery disease. But not all the people subsequently underwent percutaneous transiuminal coronary angioplasty. With the advent of multi –detector row technology combined with subsecod rotation and retrospective electrocardiographic(ECG)gating, computed tomography (CT) has become a clinica1ly important noninvasive diagnostic technique in cardiac imaging .We studied retrospectively 82 patients who had undergone 16-slice spiral CT, to investigate the clinical ap... |
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