【摘要】 目的：探讨冠状动脉重构在冠心病发生中的作用以及与临床表现之间的关系。方法：73例冠心病患者,根据临床表现分为急性心肌梗死(AMI)组,共27例；不稳定性心绞痛(UAP)组,共22例；稳定性心绞痛(SAP)组,共24例。对“罪犯”病变进行血管内超声(IVUS)检查,测定重构指数,确定重构方向,并进行分组对比研究。结果：正性重构在急性心肌梗死组最常见,其次为不稳定性心绞痛组,稳定性心绞痛组最少见。相反,负性重构在稳定性心绞痛组最常见,其次为不稳定性心绞痛组,急性心肌梗死组最少见。正性重构病变有较大的外弹力膜面积、斑块面积和斑块负担。结论：正性重构与急性冠状动脉综合症的发生有关,负性重构易引起心绞痛的发生却使斑块趋于稳定。更多还原

【Abstract】 Objective:To investigate the remodeling characteristics of coronary lesions in vivo by intravascular ultrasound,and to evalu- ate the relationship between coronary,arterial remodeling and clinical presentations. Methods:Seventy-three patients with coronary artery disease were studied using intravascular ultrasound before coronary in- tervention.The patients were divided into three groups according to the clinical presentations:the group of acute myocardial in- farction;the group of unstable angina pectoris and the group of stable angina pectoris.The remodeling indexes were calculated, and the directions of remodeling were determined.The characteristics of each group were compared. Results:Positive remodeling was more frequent in patients with acute myocardial infarctions than in patients with unstable angina pectoris,and the least frequent in patients with stable angina pectoris,whereas negative remodeling was more frequent in stable angina pectoris than in patients with unstable angina pectoris,and the least frequent in patients with acute myocardial in- farctions. Conclusions:The positive remodeling is associated with acute coronary syndromes.The negative remodeling is liable to in- duce the attack of angina pectoris,but it can make the plaques stable.更多还原