冠状动脉慢血流现象与血管内皮功能紊乱有相关性  

Relationship between coronary slow flow and endothelial disorder

作　　者：李祥廷[1] 张少阳[2] 邢冰[3] 武宗寅[3] 

机构地区：[1]济宁医学院附属医院心内科,山东济宁272000 [2]聊城市人民医院心内科,山东聊城252000 [3]济宁市第一人民医院心内科,山东济宁272000

出　　处：《心脏杂志》2016年第2期163-165,178,共4页Chinese Heart Journal

摘　　要：目的探讨冠状动脉慢血流（CSF）现象与血管内皮功能的相关性。方法选取2012年10月~2013年10月在济宁市第一人民医院心内科住院，经冠状动脉造影（CAG）证实为CSF且无冠状动脉狭窄、冠状动脉畸形及血栓形成的患者60例作为慢血流组，同时随机选取同期CAG证实血流正常且无冠状动脉狭窄、冠状动脉畸形及血栓形成的患者20例作为对照组。通过高分辨率多普勒超声仪测定两组患者的基础肱动脉内径（D0）、肱动脉内皮依赖血流量介导的舒张反应（FMD）及非内皮依赖的硝酸甘油介导的舒张反应（NID），以此反应两组患者的血管内皮功能。对慢血流组与对照组患者的性别、年龄、体质量指数（BMI）、吸烟比例、血脂、空腹血糖、血压、血管内皮功能指标进行组间比较和相关性分析。结果慢血流组与对照组在年龄、BMI、空腹血糖、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、舒张压水平等方面均无统计学差异；慢血流组吸烟比例（63% vs. 25%）、收缩压水平〔（126±12）mmHg vs.（119±13）mmHg〕均高于对照组（P〈0.05）；慢血流组男性比例（78% vs. 30%）显著高于对照组（P〈0.01）；慢血流组与对照组相比D0、NID无统计学差异；慢血流组FMD显著低于对照组〔（6.3±1.3）% vs.（10.2±1.9）%，P〈0.01〕，其平均血流帧数与FMD呈明显负相关（r=-0.70，P〈0.01）。结论冠状动脉慢血流现象与内皮功能紊乱有相关性。AIM To study the relationship between coronary slow flow （CSF） and endothelial disorder. METHODS Sixty CSF patients confirmed by coronary angiography （CAG） and determined by corrected TIMI frame count （CTFC） method and 20 patients with normal coronary angiography were assigned, respectively, to CSF group and control group （CNF group）. Brachial artery diameter, brachial artery endothelium-dependent blood flow-mediated dilation response （FMD） and nitroglycerin-mediated nonen- dothelium-dependent relaxation response （NID） were measured by high-resolution Doppler ultrasound. Gender, age, body mass index （BMI）, smoking rate, blood lipids, fasting blood glucose, blood pressure and endothelial function indicators were compared between groups. RESULTS No significant differences were found in age, BMI, fasting blood sugar, TC, TG, LDL-C, HDL-C, and diastolic blood pressure between groups. The proportion of smoking （63% vs. 25% ） and systolic blood pressure [ （126 ±12） mmHg vs. （ 119 ± 13 ） mmHg] in CSF group was higher than those in the CNF group （ P 〈 0. 05 ）. The proportion of males in the CSF group was significantly higher than in the CNF group （78% vs. 30% , P 〈0. 01 ）. No significant differences in DO and NID were found between groups. FMD in the CSF group was significantly lower than in control group [ （6. 28 ± 1.30） % vs. （ 10. 2 ± 1.9） %, P 〈0. 01 ] and the frame count of CSF group was negatively correlated with FMD （Pearson correlation coefficient, r = -0. 70, P 〈0. 01 ）. CONCLUSION CSF is related to endothelial disorder, but other risk factors should also be taken into consideration.

关 键 词：冠状动脉慢血流 血管内皮功能 

分 类 号：R541.4[医药卫生—心血管疾病]