经皮冠状动脉介入治疗对急性冠状动脉综合征患者内皮功能的影响

目的了解急性冠状动脉综合征患者的内皮功能及经皮冠状动脉介入治疗对内皮功能的影响。方法共入选120例急性冠状动脉综合征患者及30例正常对照者,采用高分辨率彩色多普勒超声仪,测定肱动脉内皮依赖性血流介导的血管舒张功能及非内皮依赖性硝酸甘油介导的血管舒张功能。急性冠状动脉综合征患者按有无接受经皮冠状动脉介入治疗分为两组,观察两组患者基线及3个月的内皮依赖性血流介导及非内皮依赖性硝酸甘油介导的血管舒张功能。结果急性冠状动脉综合征患者的内皮依赖性血流介导的血管舒张功能明显低于正常对照组(8.29±5.11比10.64±3.82,P=0.029),而两组间非内皮依赖性硝酸甘油介导的血管舒张功能无明显差别(20.37±9.29比18.41±5.83,P=0.226);经皮冠状动脉介入治疗组术后3个月的内皮依赖性血流介导的血管舒张功能较术前明显降低(5.26±7.20比7.86±5.51,P=0.037),而药物治疗组的内皮依赖性血流介导的血管舒张功能前后对比无明显变化(7.14±6.99比7.91±4.52,P=0.401);内皮依赖性血流介导的血管舒张功能在两组之间及各组治疗前后无统计学差别(P>0.05)。结论急性冠状动脉综合征患者存在内皮功能受损;经皮冠状动脉介入治疗进一步加重内皮功能障碍。

Effect of Percutaneous Coronary Intervention on Endothelial Function in Patients With Acute Coronary Syndrome

Aim To investigate the endothelial function in patients with acute coronary syndrome (ACS) and the effect of percutaneous coronary intervention (PCI) therapy on endothelial function. Methods Endothelium- dependent flow-mediated dilation (FMD)and endothelium-independent nitroglycein-mediated dilation (NMD)of brachial artery were assessed by high-resolution color Doppler ultrosound. One hundred and twenty patients with ACS and thirty control subjects were enrolled in the study. First, the groups were matched for age, sex and other risk factors, people with hypertension and diabetes were excluded. FMD and NMD of two groups were compared. Second, basline FMD and NMD of all patients were measured. Then, patients were divided into PCI and medical groups. FMD and NMD for basline and three months later of two groups were compared. Results Compared with healthy controls, ACS patients had lower FMD (8.29±5.11 vs 10.64±3.82, P=0.029), but equal NMD (20.37±9.29 vs 18.41±5.83, P=0.226); For PCI group, FMD of basline and three months later was (7.86±5.51, 5.26±7.20), respectively (P=0.037); while of medical group, FMD of basline and three months later was (7.91± 4.52 , 7.14±6.99), respectively (P=0.401), No significant difference was found in NMD between two groups, before and after therapy (p>0.05). Conclusions The endothelial function was impaired in ACS patients; The treatment of PCI augment endothelial dysfunction.