Relationship between plasma inflammatory markers and plaque fibrous cap thickness determined by intravascular optical coherence tomography
Relationship between plasma inflammatory markers and plaque fibrous cap thickness determined by intravascular optical coherence tomography
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血管内光学相干断层扫描测定血浆炎症标志物与斑块纤维帽厚度的关系
DOI：
10.1136/hrt.2009.175455
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发表时间：
2010-02-01
期刊：
影响因子：
5.7
通讯作者：
Liao, Y-H
中科院分区：
文献类型：
--
作者：
Li, Q-X;Fu, Q-Q;Liao, Y-H
目的探讨血管内光学相干断层扫描（OCT）检测冠心病患者斑块纤维帽厚度与血浆炎症因子水平的关系。方法与结果应用OCT检测急性心肌梗死（AMI）、不稳定型心绞痛（UAP）和稳定型心绞痛（SAP）患者冠状动脉粥样硬化斑块的纤维帽厚度。采用ELISA法检测血浆高敏C反应蛋白（hs-CRP）、白细胞介素18（IL-18）和肿瘤坏死因子α（TNFα）水平，并进行外周血白色细胞（WBC）计数。结果表明，血浆炎症因子水平和WBC计数与纤维帽厚度呈负相关（hs-CRP r =-0.775，IL-18 r =-0.593，TNFα r =-0.60，WBC计数r =-0.356）。帽厚度小于65 μm的患者（定义为薄帽纤维粥样硬化; TCFA）的血浆炎症因子水平以及WBC计数高于纤维帽较厚的患者。hs-CRP、IL-18、TNFα和WBC计数的ROC曲线下面积分别为0.95、0.86、0.79和0.70（p<0.05），对TCFA具有预测能力。ROC曲线分析证实，1.66 mg/l的hs-CRP临界值检测TCFA的灵敏度为96%，特异性为90%，是TCFA最强的独立预测因子。结论纤维帽厚度与血浆炎症标志物水平呈负相关。血浆hs-CRP浓度是TCFA最强的独立预测因子。
Objective The purpose of this study was to evaluate the relationship between human plaque fibrous cap thickness detected by intravascular optical coherence tomography (OCT) and the plasma levels of inflammatory factors in patients with coronary artery disease (CAD). Methods and Results OCT was used to measure the fibrous cap thickness of coronary artery atherosclerotic plaques in patients with acute myocardial infarction (AMI), unstable angina pectoris (UAP) and stable angina pectoris (SAP). Plasma levels of inflammatory factors including highly sensitive C-reactive protein (hs-CRP), IL-18 and tumour necrosis factor alpha (TNFα) were detected by ELISA, and peripheral white blood cell (WBC) counts were performed. The results demonstrated that the plasma levels of inflammatory factors and WBC count were correlated inversely with fibrous cap thickness (r = −0.775 for hs-CRP, r = −0.593 for IL-18, r = −0.60 for TNFα and r = −0.356 for WBC count). Patients with cap thickness less than 65 μm (defined to be thin cap fibroatheromas; TCFA) had higher plasma levels of inflammatory factors as well as WBC counts than those with thicker fibrous caps. Receiver operator characteristic (ROC) curves for hs-CRP, IL-18, TNFα and WBC count, which displayed the capability of prediction about TCFA, showed the area under the curves were 0.95, 0.86, 0.79 and 0.70 (p<0.05), respectively. ROC curve analysis confirmed that an hs-CRP cut-off at 1.66 mg/l would detect TCFA with a sensitivity of 96% and a specificity of 90%, and was the strongest independent predictor of TCFA. Conclusion There is an inverse linear correlation between fibrous cap thickness and plasma levels of inflammatory markers. The plasma hs-CRP concentration is the strongest independent predictor of TCFA.