吸烟对血管造影无明显狭窄患者血清E-选择素、高敏C反应蛋白水平以及冠状动脉血流状态的影响  

The effect of smoking on serum levels of soluble E-selectin and high sensitivity C-reaction protein and coronary flow in angiography without obvious arteries stenosis

作　　者：贺立群[1] 张帆[1] 王顺[1] 李佐民[1] 昌薇[1] 柯于鹤[1] 邓次妮[1] 冷沁[1] 郑蓉[1] 陈海云[1] 欧阳银娥 雷健[1] 

机构地区：[1]武汉市第一医院心内科,430022

出　　处：《临床内科杂志》2015年第8期526-528,共3页Journal of Clinical Internal Medicine

基　　金：武汉市卫生局资助课题（2010WX10C05）

摘　　要：目的探讨吸烟影响冠状动脉血流状态的可能机制，了解吸烟在冠状动脉慢血流（scr）现象中所起的作用。方法收集2010年11月～2013年6月在我院行冠状动脉造影检查未发现明显冠状动脉狭窄的患者60例，采用平均心肌梗死溶栓治疗（TIMI）血流帧数计数评价冠状动脉的血流速度，根据当前是否吸烟被分为吸烟组（cs组，33例）以及非吸烟组（NS组，27例），比较两组患者的临床特点、冠状动脉血流速度、血清可溶性E一选择素（SES）、高敏C反应蛋白（hs—CRP）水平，并对炎症反应因子与冠状动脉血流速度之间的关系进行分析。结果cs组与Ns组患者血清SES[（60．23±4．21）ng／ml与（39．33±2．89）ng／ml，P〈0．01]、hs—CRP[（5．44±1．67）mg／L与（2．66±O．22）mg／L，P〈0．01]水平比较，cs组明显高于Ns组。两组SCF发生率（63．64％与33．33％，P〈0．01）、平均TIMI血流帧数[（35．69±2．45）帧与（25．19±1．97）帧，P〈0．01]Cs组亦明显高于Ns组。hs．CRP水平的高低与平均TIMI帧数呈明显正相关（r=0．830，P〈0．01）。结论吸烟可激发系统炎症反应，进而影响患者冠状动脉的血流状态，这可能是吸烟患者发生SCF现象的原因之一。Objective： To investigate the effect of smoking on coronary flow and its possible mechanism. Methods A total of 60 patients without obvious coronary artery stenosis were divided into current smoking group（ CS group, n = 33 ） and non smoking group（ NS group, n = 27 ）. Coronary flow pat- terns were determined by thrombolysis in myocardial infarction （TIMI） frame count. Clinical manifesta- tions, coronary flow, the serum soluble E-selectin（SES） and high sensitivity C-reaction protein （hs-CRP） levels of two groups were analyzed retrospectively. Results Serum SES and hs-CRP levels of current smokers were found to be significantly higher than those of non-smokers[ SES： （60.23 ± 4.21 ） ng/ml vs （39.33 ±2.89） ng/ml, P 〈 0.01, hs-CRP ： （5.44 ±1.67 ） mg/L vs （2.66 ± 0.22） mg/L, P 〈 0.01 ]. Mean TIMI frame count was significantly higher in CS group than that of NS group [ （ 35.69 ± 2.45 ） vs （25.19 ± 1.97 ）, P 〈 0.01 ]. There was a high incidence of slow coronary flow phenomenon （SCF） in smokers（63.64% vs 33.33% ,P 〈 0.01 ）. Serum level of hs-CRP was positively correlated with the aver- age TIMI frame count（ r = 0. 083, P 〈 0.01 ）. Conclusion Smoking could promote system inflammation response and deteriorate coronary flow, and this may be one of the reasons for phenomenon of slow coronary flow in smokers.

关 键 词：吸烟 冠状动脉血流 可溶性E-选择素 高敏C反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]