摘要目的 探讨老年急性冠脉综合征(ACS)患者的衰减斑块特点. 方法 2013年1月至2014年12月期间符合条件的166例ACS患者为研究对象.记录一般临床资料、冠脉造影血管病变情况和罪犯斑块的血管内超声特点,主要包括有无衰减斑块、最大衰减回声弧度、血管外弹力膜面积、管腔面积、斑块面积,计算斑块负荷和重塑指数. 结果 与非老年组相比老年组多支冠脉病变的比例较高(50.0％和35.1％,x2=6.525,P=0.038),衰减斑块较多(62.0％和45.9％％,x2=4.245,P=0.039),最大衰减回声弧度[(142±80)°和(115±54)°,t=5.254,P=0.000]、斑块面积[(14.2±3.9)mm2和(12.3±4.1)mm2,t=2.325,P=0.022]、斑块负荷[(81.1±14.2)％和(76.4±13.5)％,t=2.025,P=0.042]和重塑指数[(1.19±0.17)和(1.09±0.13),t=4.245,P=0.031]较大. 结论 老年ACS患者的发病与不稳定斑块的关系更为密切,加强稳定斑块的治疗措施将有助于老年ACS的防治.

abstractsObjective To explore the characteristics of attenuated plaque (AP) in culprit lesions for acute coronary syndrome (ACS) in elderly patients.Methods This study included 166 ACS patients meeting the conditions from Jan.1, 2013 to Sep.31, 2014.Clinical data, vascular lesions determined by coronary angiography and intravenous ultrasound (IVUS)-demonstrated characteristics of culprit plaque, which included presence of AP, maximum attenuation arc, extravascular elastic membrane area, lumen area, plaque area, plaque burden and remodeling index, were recorded.Results Compared with non-elderly group, elderly group had a higher proportion of multiple coronary-artery lesions (50.0％ vs.35.1％, x2=6.525, P =0.038), more attenuation plaques (62.0 ％ vs.45.9％, x2 =4.245, P=0.039), a larger maximum attenuation arc[(142±80)° vs.(115±54)°, t=5.254, P=0.000], larger plaque area[(14.2±3.9)mm2 vs.(12.3 ± 4.1) mm2, t=2.325, P=0.022], more plaque burden [(81.1±14.2)％ vs.(76.4±13.5)％, t=2.025, P=0.042] and higher remodeling index [(1.19±0.17) vs.(1.09±0.13), t=4.245, P=0.031].Conclusions The onset of ACS is more closely related with the unstable plaque in elderly patients, and strengthening the measures for plaque stabilization will be helpful in the prevention and treatment of ACS in the elderly.