心血管病一级预防对非阻塞性冠状动脉粥样硬化胸痛患者血管内皮功能和生活质量的影响  

Effect of primary prevention of cardiovascular disease on vascular endothelial function and quality of life in patients with non-obstructive coronary atherosclerosis chest pain

作　　者：谭静[1] 高敬[1] 张迎花[1] 司瑾[1] 左雪冰 李静[1] Tan Jing;Gao Jing;Zhang Yinghua;Si Jin;Zuo Xuebing;Li Jing(Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院心脏内科,北京100053

出　　处：《中国心血管杂志》2021年第1期42-45,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨心血管病一级预防措施对非阻塞性冠状动脉粥样硬化胸痛患者血管内皮功能和生活质量的影响。方法选取2013年6月至2015年6月首都医科大学宣武医院心脏内科收治的因胸痛疑诊冠心病、经冠状动脉造影检查证实为非阻塞性冠状动脉粥样硬化症(冠状动脉管腔狭窄<50%)的患者109例。采用标准化问卷调查记录患者临床资料,随访1年进行用药指导、健康知识宣教和心理疏导,用健康调查简表(SF-36)评价生活质量,行肱动脉血流介导的内皮依赖性血管舒张功能(FMD)检测。结果与基线比较,随访1年时患者应用抗血小板药物(59.6%比19.3%,χ2=37.178,P<0.001)、血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗剂(48.6%比28.4%,χ2=9.374,P=0.002)、β1受体阻滞剂(54.1%比22.9%,χ2=22.389,P<0.001)和他汀类药物(69.7%比22.0%,χ2=49.955,P<0.001)的比例均显著增加,FMD(8.7%±6.0%比7.0%±6.2%,t=3.966,P<0.001)和SF-36生活质量评分(69.7±9.0比65.0±8.9,t=5.437,P<0.001)均显著改善。结论本研究观察到,在以胸痛就诊的非阻塞性冠状动脉粥样硬化人群中,心血管病一级预防可有效改善患者血管内皮功能、提高生活质量。Objective To explore the effect of primary prevention of cardiovascular disease on flow mediated dilatation(FMD)and quality of life(QOL)in patients with non-obstructive coronary atherosclerosis.Methods Consecutive patients with suspected coronary artery disease and confirmed non-obstructive coronary atherosclerosis(coronary stenosis<50%)via coronary angiography were prospectively enrolled between June 2013 and June 2015 in Cardiology Department of Xuanwu Hospital.Clinical data were investigated by standard questionnaire.Follow-up period was 1 year.Medication consultation,health education and psychological counseling were provided.FMD was measured,and QOL was measured with short-form 36 item(SF-36)questionnaire.Results Compared with baseline,patients were treated with antiplatelet agents(59.6%vs.19.3%,χ2=37.178,P<0.001),angiotensin converting enzyme inhibitor or angiotensinⅡreceptor blockers(48.6%vs.28.4%,χ2=9.374,P=0.002),β1-blocker(54.1%vs.22.9%,χ2=22.389,P<0.001)and statins(69.7%vs.22.0%,χ2=49.955,P<0.001)increased significantly at 1-year follow-up.FMD(8.7%±6.0%vs.7.0%±6.2%,t=3.966,P<0.001)and SF-36 questionnaire score(69.7±9.0 vs.65.0±8.9,t=5.437,P<0.001)were improved significantly.Conclusions Primary prevention of cardiovascular disease could improve FDM and QOL in patients with non-obstructive coronary atherosclerosis.

关 键 词：非阻塞性冠状动脉粥样硬化 胸痛 心血管疾病 一级预防 血管内皮功能 生活质量 

分 类 号：R54[医药卫生—心血管疾病]