冠心病患者血管内皮功能与冠脉狭窄程度的相关性分析  

The Correlation between Vascular Endothelial Function and Severity of Coronary Artery Stenosis in Patients with Coronary Artery Disease

作　　者：林岳武[1] 杜心清[2] 

机构地区：[1]福建医科大学附属漳州市医院,福建漳州363000 [2]福建医科大学附属第二医院,福建泉州362000

出　　处：《吉林医学》2017年第9期1679-1682,共4页Jilin Medical Journal

摘　　要：目的:使用高分辨率超声测量肱动脉血流介导的内皮依赖性血管舒张功能(FMD)来进行准确、定量的评价血管内皮功能,分析冠心病(CAD)患者血管内皮功能与其冠脉狭窄程度的相关性。方法:选用疑似冠心病备行冠脉造影的患者共137例,收集所有患者的临床基线情况,在冠脉造影(CAG)之前对其行无创高频超声FMD检查,记录FMD数值。行中心导管选择性冠状动脉造影,冠脉主要分支狭窄程度≥50%的即为冠心病组(CAD组,n=89),主要分支狭窄程度<50%的即为非冠心病组(非CAD组,n=48)。根据CAG结果得出Gensini积分,以此来评价患者的冠状动脉狭窄程度。分析FMD与冠脉狭窄程度的关系。结果:(1)根据选择性CAG检查情况,CAD组89例,非CAD组48例。通过比较CAD组与非CAD组的临床因素结果发现,两组在性别构成、吸烟、高血压、糖尿病、HDL-C、LDL-C、HCY等方面比较差异有统计学意义(P<0.05),其他临床因素比较差异无统计学意义(P>0.05);(2)CAD组的FMD数值比非CAD组的低(4.83±2.57)%vs(9.75±2.27%),差异有统计学意义(P<0.001)。CAD组内的分析表明,随着冠脉病变支数的增加,FMD数值不断下降(P<0.05)。(3)ROC曲线分析表明,FMD的ROC曲线下面积大于其他临床因素,在冠心病的诊断及预测冠脉狭窄程度方面更有价值。结论:高频超声检测的FMD对于冠心病患者冠脉诊断具有较好的预测价值,并与其冠脉狭窄的严重程度密切相关。Objective It had been found that the endothelial function of the brachial artery can be evaluated accurately and quantitatively by noninvasive ultrasound evaluation of brachial artery flow mediated dilation（ FMD）. The purpose of this study was to investigate the relationship between the vascular endothelial function and the degree of coronary stenosis of patients with coronary artery disease（ CAD）. Method Coronary angiography（ CAG） was performed in 137 patients with suspected CAD. The clinical baseline conditions were collected from all patients. High-frequency ultrasound was used to detect the flow mediate dilation（ FMD） at the first day of operation. Thus,the patients can be devided into two groups： CAD group（ with more than 50% degree of coronary stenosis） and Non-CAD group（ with less than 50% degree of cornonary stenosis）. The Gensini score of the CAD group was assessed to detect the degree of stenosis of blood vessels. Then the relationship between FMD and coronary artery stenosis was analyzed. Results（1）According to the results of CAG,89 patients were enrolled into the CAD group with 48 patients into the Non-CAD group. By comparing the clinical factors between CAD group and Non-CAD,we found that there was significant difference in sex ratio,smoking,hypertension,diabetes,HDL-C,LDL-C,and Hcy factors between these two groups（ P 〈0. 05）,while there was no difference in other factors（ P 〉 0. 05）;（2）the FMD values of the coronary heart disease group were significantly lower than Non-CAD group（ 4. 83 ± 2. 57） % vs（ 9. 75 ± 2. 27） %,the difference was statistically significant（ P 〈0. 001）. Coronary heart disease group analysis showed that with the increase in the number of diseased coronary artery,the FMD values gradually decline. The difference was statistically significant（ P 〈 0. 05）.（3）ROC curve analysis showed that the area under the ROC curve of FMD was larger than other clinical factors,and it was more valuable in the diagnosis and predi

关 键 词：冠心病 血管内皮功能 冠脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]