外周血CGRP、SP水平及HRV与冠状动脉粥样硬化病变的关系研究

目的 观察冠状动脉造影患者血浆降钙素基因相关肽（CGRP）、P物质（SP）水平和心率变异（HRV）与冠状动脉粥样硬化严重程度的关系.方法 分析172例冠状动脉造影患者,135例诊断为冠心病,其中单支病变54例,双支病变41例,三支病变40例,冠状动脉造影阴性37例,采用放射免疫法检测入选患者的CGRP、SP水平和动态心电图检测HRV.结果 冠心病患者血浆CGRP含量均低于冠状动脉造影阴性组（P〈0.05）,其中冠状动脉造影阴性组与双支病变组、三支病变组比较,单支病变组与三支病变组比较,CGRP含量均明显升高,差异有显著性（P〈0.01）,冠心病三支病变的患者血浆SP含量均低于单支病变组（P〈0.05）及冠状动脉造影阴性组（P〈0.01）.正常窦性R-R间期标准差（SDNN）在冠心病三支病变的患者中均显著低于单支病变组及冠状动脉造影阴性组（P〈0.01）,双支病变组的患者均低于冠状动脉造影阴性组（P〈0.05）;每5mm的R-R间期标准差的平均值（SDNN index）在冠心病三支病变的患者中均显著低于单支病变组（P〈0.05）及冠状动脉造影阴性组（P〈0.01）,在双支病变的患者中均低于冠状动脉造影阴性组（P〈0.05）.结论 冠心病患者CGRP水平降低,CGRP、SP、HRV有关参数的降低与冠状动脉狭窄程度有密切关系,CGRP、SP与HRV联合检测可以作为评估冠心病患者冠状动脉病变程度及危险性的指标.

Correlation of blood calcitonin gone-related peptide, substance P and heart rate variability with the severity of coronary atherosclerosis

Objective To investigate the correlation of blood calcitonin gene-related peptide （CGRP）, substance P （SP） and heart rate variabirity with the severity of coronary atherosclerosis. Methods A total of 172 patients were randomly selected who attended the cardiovascular department of the first affiliated hospital of Zhejiang university medical college. The CHD patients included cases with single vascular lesions （n= 54）, two vascular lesions （n= 41） and three vascular lesions （n= 40）. The plasma CGRP and plasma SP concentrations were evaluated by RIA system, HRV was tested by DCG. Results CGRP concentrations were significantly lower in CHD group than that in control group （P〈 0.05）. In CHD group the plasma CGRP concentration of patients with single vascular lesions was higher than that of three vascular lesions （P〈0. 01）. SP levels in plasma were lower in CHD group with three vascular lesions than single vascular lesions （P〈0. 05） and that in control group （P〈0.01）. SDNN in CHD group with three vascular lesions was significantly lower than that of single vascular lesions and that in control group （P〈0. 01）; and that of two vascular lesions was significantly lower than that in control group （P〈0. 05）. SDANN in CHD group with three vascular lesions was significantly lower than that of single vascular lesions and that in control group （P〈0.05）. SDNN index in CHD group with three vascular lesions was significantly lower than that of single vascular lesions and that of control group （P〈0.01）; and that of two vascular lesions were significantly lower than that in control group （P〈0.05）. Conclusion Results suggest that the plasma concentrations of CGRP and SP combined with HRV levels can be used for the indicators of the severity of coronary artery stenosis.