血管活性物质与超敏C反应蛋白及颈动脉病变对冠心病发病的影响因素分析

目的探讨血管活性物质、超敏C反应蛋白（hsCRP）水平及颈动脉病变对冠心病发病的影响。方法住院行介入治疗的冠心病患者99例，以单纯高血压患者122例为对照，测定其血脂、血浆同型半胱氨酸（Hcy）、一氧化氮（NO）、hsCRP水平，并行颈动脉超声检查。结果冠心病患者血浆Hcy水平为（18．57±7．47）μmol／L，明显高于单纯高血压组（14．53±10．58）μmol／L，P=0．002]；hsCRP水平为（3．73±3．89）mg／L，明显高于单纯高血压组（2．38±2．86）mg／L，P=0．008]。冠心病患者血清NO水平为（51．15±18．78）μmol／L，明显低于单纯高血压组（70．39±41．55）μmol／L，P=0．000]。冠心病组颈动脉病变占94．1％，明显高于高血压组（P=0．000）。多元回归分析显示低TC、高Hey、低NO、高hsCRP水平是冠心病发病的独立影响因素（P〈0．05）。结论高Hey水平、低NO水平以及颈动脉病变与冠心病发生明显相关，因此血管活性物质测定及简单、无创、重复性好的颈动脉超声有望成为观察冠状动脉病变的窗口。

Correlation between Plasma Vasoactive Substances,High-sensitivity C-reactive Protein,and Carotid Artery Lesions and Coronary Heart Diseases

Objective To investigate the influences of plasma vasoactive substances,high-sensitivity C-reactive protein(hsCRP),and carotid artery lesions on coronary heart disease (CHD).Methods Plasma homocysteine (Hcy),nitric oxide (NO),and hsCRP levels were measured in 99 hospitalized patients with coronary heart disease (CHD group),while 122 patients with essential hypertension (EH group) were act as controls.Carotid artery ultrasound was performed.Results Serum Hcy was (18.57±7.47) μmol / L in CHD group,which was significantly higher than that in EH group (14.53±10.58) μmol / L (P＜0.01 ).Serum NO in CHD group (51.15±18.78) μmol/L] was significantly lower than that in EH group (70.39 ±41.55) μmol / L] (P＜0.001).Carotid artery lesions were found in 94.1% of patients in CHD group,which was significantly higher than that in EH group (P＜0.001).Conclusion High homocysteinemia,low plasma NO,and carotid artery lesions are closely correlated with the occurrence of coronary heart disease.Vasoactive substances measurement and carotid artery ultrasound are useful tool in detecting coronary artery diseases.