冠心病患者冠状动脉病变血管数与高敏C反应蛋白、颈动脉斑块分级和内皮功能的相关性

目的探讨冠心病患者冠状动脉病变血管数与高敏C反应蛋白(hsCRP)、内皮依赖血管舒张功能、颈动脉内膜中层厚度(IMT)和斑块积分的相关性。方法采用高分辨率血管超声法检测76例冠心病患者与30例非冠心病对照组肱动脉血流介导的内皮依赖性血管舒张功能(FMD)、颈动脉IMT及斑块积分;并检测患者血液中hsCRP水平,对冠心病患者进行冠状动脉造影,根据冠状动脉病变血管数将冠心病患者分为3组:单支病变组、双支病变组及三支病变组。结果冠心病患者的血浆hsCRP显著高于对照组,FMD在冠心病各亚组中明显降低,与对照组比较差异有统计学意义(均为P<0.05);IMT在冠心病组中明显增厚,与对照组比较差异有统计学意义(均为P<0.05);颈动脉斑块积分在冠心病各亚组间比较差异有统计学意义(P<0.05)。冠心病患者冠状动脉病变血管数与血浆hsCRP及斑块积分呈正相关,与FMD呈负相关。结论血浆hsCRP、FMD及颈动脉斑块积分的检测与冠心病患者冠状动脉病变支数相关。

Correlations among hsCRP,carotid artery plaque scores and the number of stenosed coronary artery in patients with coronary heart disease

Objective To investigate the correlations among hsCRP, flow-mediated dilation (FMD), common carotid artery intima-media thickness (IMT) and plaque scores with the number of stenosed coronary artery in patients with coronary heart disease (CHD). Methods Seventy-six patients with CHD and 30 normal controls were recruited for this study. FMD in brachial artery, IMT and arteriosclerotic plaques in carotid arteries were evaluated with B-mode ultrasonography in all subjects. Patients with CHD were divided into 1-vessel disease group, 2-vessels disease group and 3- vessels disease group according to the results of coronary angiography. Plasma hsCRP was measured before angiography. Results IMT and hsCRP were significantly higher in CHD group than in control group ( both P < 0. 05 ) . FMD was significantly lower in CHD group than in control group ( P < 0. 05). Both hsCRP and atherosclerosis plaque scores were positively correlated with the number of stenosed coronary artery in patients with CHD ( r = 0. 64 and 0.41 respectively, both P<0. 05). FMD was negatively correlated with the number of stenosed coronary artery in patients with CHD (r = -0.43, P < 0. 05). Conclusions The present study suggests there exist correlations among hsCRP, FMD and atherosclerosis plaque scores in carotid artery and the number of stenosed coronary artery in patients with CHD.