冠状动脉慢血流综合征与血浆ET-1、TAT、hs—CRP的相关性研究  

Study on the relationship between the plasma levels of ET-1, TAT, and hs-CRP and slow coronary flow syndrome

作　　者：马玲[1] 张金国[1] 尉希清[1] 陈猛[1] 谭洪勇[1] 

机构地区：[1]济宁医学院附属医院心内科,山东省济宁272029

出　　处：《中国医师杂志》2013年第11期1526-1529,共4页Journal of Chinese Physician

摘　　要：目的观察冠状动脉慢血流综合征（SCFS）与血浆内皮素（ET-1）、凝血酶抗凝血酶复合物（TAT）、高敏C反应蛋白（hs—CRP）水平之间的相关性，探讨冠状动脉内皮功能、凝血功能、炎症反应对冠状动脉血流的影响。方法随机选择400例行冠脉造影（CAG）显示冠状动脉无明显病变的患者，通过校正TIMI血流计帧法（cTFC）计算各支冠状动脉的血流帧数。筛查出SCFS患者45例，作为研究组；随机选择另外45例无SCFS的患者为对照组。应用t检验和X。检验比较两组临床资料的差异，并采用logistic回归分析SCFS的高危因素。结果研究组的高密度脂蛋白明显低于对照组[（1．22±0．42）mmol／Lvs（1．44±0．34）mmol／L，t=-2．731，P〈0．01]，血糖水平明显高于对照组[（5．68±0．62）mmol／LVS（5．10±0．84）mmol／L，t=3．727，P〈0．01]，血浆ET-1、TAT、hs—CRP水平高于对照组[（94．3±16．78）ng／Lvs（83．5±12．53）ng／L，t=3．051，P〈0．01；（12．96±3．24）μg/Lvs（8．76±2．64）μg／L，t=5．945，P〈0．01；（2．48±0．35）μg／LVS（1．58±0．46）μg／L，t=11．259，P〈0．01]，logistic回归分析表明吸烟、血清胆固醇、ET．1、TAT、hs—CRP是影响SCFS的危险因素（OR〉1．22）。结论由于冠状动脉的内皮功能障碍以及炎症反应，出现动脉硬化，导致凝血功能活化，冠状动脉出现慢血流。Objective To investigate the relationship between the plasma levels of ET-1, TAT, and hs-CRP and slow coronary flow syndrome （SCFS） , and explore effects of coronary endothelial function, coagulation function, and inflammatory reaction on blood flow of coronary artery. Methods A total of 400 cases with normal blood flow of coronary artery by coronary angiogram was randomly selected. The coronary flow patterns were determined by corrected thrombolysis in myocardial infarction frame count method （cT- FC）. Among them, 45 cases whose average cTFC more than 27 were assigned as SCFS group, the other 45 cases no SCFS. Plasma levels of ET-1, TAT and hs-CRP were examined with enzyme-linked immunosorbent assay （ELISA）, and were compared between two groups. Moreover, multivariate analysis evaluating predic- tors of SCFS was performed with regression test. Results No statistical difference was found between two groups concerning the gender, history of hypertension, diabetes mellitus, and cigarette alcohol percentage.. The plasma level of HDL in SCFS group was lower than that of no SCFS [ （ 1.22 ± 0. 42） mmo]/L vs （ 1.44 ±0. 34） mmol/L, t = 2. 731, P 〈0. 01 ] , but the plasma level of glucose in the former was higher than that of the latter [ （5.68 ±0. 62） mmoL/L vs （5.10 ±0. 84） mmo]/L, t =3.727, P 〈0.01 ]. However, Plasma levels of ET-1, TAT and hs-CRP in SCFS were higher than that of no SCFS [ （94. 3 ± 16. 78） ng/Lvs （83.5±12.53） ng/L, t =3.051, P 〈 0. 01; （12. 96 ± 3. 24 ）μg/L vs （8.76 ± 2. 64 ） μg/L, t = 5. 945, P 〈 0. 01 ; （2.48 ±0. 35） μg/L vs （ 1.38 ± 0. 46） μg/L, t = 11. 259, P 〈 0. 01 ]. Furthermore, Logistic regression analysis showed that ET-1, TAT and hs-CRP were risk factors for SCFS （ OR 〉 1.22）. Conclusions Due to coronary endothelial dysfunction, endothelial inflammatory reaction, and activated co- agulation function, slow coronary flow of coronary artery occurs.

关 键 词：冠状血管 血流动力学 心肌缺血 综合征 内皮缩血管肽类 血液 抗凝血酶类 分析 凝血酶 分析 C反应蛋白质 分析 冠状血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病]