多普勒组织成像评价冠心病患者左心室舒张功能与血浆血管性假血友病因子、P选择素、内皮素-1的关系  

Correlation between von Willebrand factor,P-selectin,endothelin-1 and left ventricular diastolic function by Doppler tissue imaging in patients with coronary artery disease

作　　者：李黎[1] 李凌[1] 刘慧萍[1] 

机构地区：[1]郑州大学第一附属医院心内科,河南郑州450052

出　　处：《临床荟萃》2007年第7期461-463,共3页Clinical Focus

摘　　要：目的探讨冠心病患者左心室舒张功能与冠状动脉血管内皮损伤的关系。方法应用二维及M型超声心动图和多普勒组织成像(DTI)观察64例冠心病患者和22例健康对照者的心脏功能,并用酶联免疫吸附法(ELISA)测定血浆血管性假血友病因子(vWF)、P选择素及内皮素-1(ET-1)水平。结果冠心病组舒张早期峰值速度(Em)低于对照组(5.87±1.00)cm/s vs(7.84±2.44)cm/s(P<0.05),舒张早期与舒张晚期峰值速度比值(Em/Am)低于对照组(0.74±0.27)vs(0.99±0.51)(P<0.05);血浆vWF(192.58±34.41)%vs(116.15±23.93)%(P<0.01)、P选择素(128.98±18.77)μg/L vs(92.25±12.88)μg/L(P<0.01)、ET-1((79.55±13.76)ng/L vs(47.21±8.67)ng/L(P<0.01)水平明显高于对照组。相关分析显示:冠心病组血浆vWF、P选择素、ET-1与Em呈良好负相关(r=-0.45,-0.52,-0.52,P<0.05)。结论DTI能反映冠心病患者心室舒张功能,DTI模式下测得的舒张功能障碍与内皮损伤、血小板活化密切相关。Objective To investigate the relationship between left ventrieular diastolic function and endothelium dysfunction in the patients with coronary artery disease（CAD）. Methods The left ventrieular function was measured in 64 CAD patients and 22 control subjects by conventional 2-dimensional Doppler echocardiography and Doppler tissue imaging（DTI） ,and the plasma yon Willebrand factor（vWF）, P-selectin and endothelin-1 （ET-1）levels were determined by enzyme-linked immunosorbent assay（ELISA）. Results Compared with those of controls, peak early diastolic velocities（Em） and the ratio of peak early diastolic velocity（Ea） over late diastolic velocity（Aa） were lower in CAD patients,Em（5.87±1.00） cm/s vs （7.84±2.44） cm/s,Em/Am（0.74±0.27） vs （0.99±0.51） （all P〈0.05）. The plasma vWF, P-selectin and ET-1 levels were higher in CAD patients than those in controis,vWF（192.58±34.41） vs （116.15±23.93） %, P-selectin（128.98 ± 18.77） μg/L vs （92.25 ± 12.88） μg/L, ET-1 （79.55 ± 13.76） ng/L vs （47.21± 8.67） ng/L （all P〈0.01）. vWF, P-selectin, ET-1 levels correlated negatively with Em assessed by DTI （r =-0.45,-0.52,-0.52, respectively, P〈0.05） in CAD patients. Conclusion The parameters derived from DTI provide a more sensitive assessment of left ventricular diastolic function, and DTI derived diastolic dysfunction was associated with platelet activation and endothelial dysfunction.

关 键 词：冠状动脉疾病 超声检查 多普勒 心室功能 左 内皮 

分 类 号：R541.4[医药卫生—心血管疾病]