冠状动脉慢血流现象的相关危险因素及地尔硫卓治疗效果的分析  

Analysis of risk factors of coronary slow flow phenomenon and the therapeutic efficacy of diltiazem

作　　者：梁彩虹[1] 章延春[1] 唐建金[1] 王明伟[1] 陈波[1] 贾恩志[1] 王连生[1] 杨志健[1] 

机构地区：[1]南京医科大学第一附属医院心内科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2009年第7期992-995,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金资助项目(30871078);南京市科技局社会发展项目资助(200401068-27)

摘　　要：目的:探讨与慢血流发生可能有关的危险因素,以及地尔硫卓治疗慢血流的疗效。方法:回顾性分析冠状动脉造影显示存在慢血流现象但冠状动脉无明显病变的31例病例作为慢血流组,并随机选取相同时期冠状动脉造影显示远端血流灌注无延迟且冠状动脉无明显病变的26例病例作为对照组。应用t检验和卡方检验比较两组间各项临床指标的差异,采用多元Logistic回归对影响慢血流的各因素进行分析,并随访慢血流患者应用地尔硫卓治疗后的疗效及心血管事件的发生情况。结果:两组患者在性别、年龄、心率、血压、血糖、血脂、凝血时间等临床指标方面无统计学差异;而慢血流组患者的血红细胞计数、尿酸水平均高于对照组,存在统计学差异。经多元Logistic回归分析表明只有尿酸是慢血流发生的独立危险因素。慢血流组患者均无心血管事件发生,但经过地尔硫卓治疗的慢血流组患者较未用地尔硫卓治疗的慢血流组患者胸部不适症状得到明显改善。结论:尿酸水平的增高可能参与慢血流发生的病理生理过程,对慢血流患者采用地尔硫卓治疗可能会改善患者的胸部不适症状。Objective：To analyze the risk factors of slow coronary flow and therapeutic effect of dihiazem. Methods：Fifty-seven coronary arteriongraphy imageology documents are analyzed retrospectively. Thirty-one patients with coronary slow flow but without coronary disease confirmed by coronary angiography were selected as slow coronary flow group,and 26 patients,without coronary slow coronary flow and coronary disease, confirmed by coronary angiography as well,were selected as control group. Clinical features,the efficacy of diltiazem on coronary slow flow and the MACE outcomes were investigated in the two groups by t test and chisquared test Results ：There was no significantly difference between the two groups in gender, age, heart rate ,blood pressure ,fasting plasma glucose,blood lipid,and coagulation time. However,levels of RBC and uric acid were significantly higher in the slow coronary flow group compared with the control group. Moreover,significant higher uric acid was observed in subjects with slow coronary flow after adjustment of age, sex, hypertension, diabetes mellitus, dyslipidemia and smoking status. None cardiovascular event occurred on the patients in slow coronary flow group. However,patients treated with dihiazem felt chest complaint lighten than those in the control group. Conclusion： High uric acid palys an important role in the pathogenesis of slow coronary flow. Diltiazem as an adjunct may further lighten chest complaint in patients with slow coronary flow.

关 键 词：慢血流 危险因素 尿酸 地尔硫卓 治疗 

分 类 号：R363[医药卫生—病理学]