冠状动脉慢血流的临床特点及其与血管内皮功能的相关性研究

目的：研究冠状动脉慢血流的临床特点及其与血管内皮功能的相关性。方法以2014年2月至2016年1月来我院就诊，经冠状动脉造影证实为冠状动脉慢血流(CSF)的患者80例作为观察组，无狭窄和CSF的患者80例作为对照组。比较两组患者血流情况和内皮功能，并通过对血浆中一氧化氮(NO)及内皮素-1(ET-1)进行测定，分析冠状动脉慢血流与血管内皮功能的相关性。结果对照组患者的吸烟率为18%，慢血流组为37%，两组差异具有统计学意义(P<0.05)；对照组患者的红细胞分布宽度(RDW)以及高敏C反应蛋白(hs-CRP)水平分别为(13.5.±0.9)%、(2.2±0.8) mg/L，慢血流组为(12.8±0.5)%、(1.4±0.5) mg/L，两者差异均有统计学意义(P<0.05)；慢血流组血浆NO (35.2±11.5)μmol/L]、ET-1(17.4±3.6) ng/L]与对照组NO (48.3±13.2)μmol/L、ET-1(15.1±2.4) ng/L]相比差异均有统计学意义(均P<0.05)；经多因素Logistic回归分析，影响CSF的独立危险因素分别为吸烟(OR=5.469，P=0.000)、RDW (OR=1.623，P=0.012)、hs-CRP (OR=2.584，P=0.000)、NO (OR=1.437，P=0.000)以及ET-1(OR=1.646，P值=0.000)。结论吸烟、红细胞分布宽度及高敏C反应蛋白水平升高可能在CSF的病理生理过程中起一定作用，而血管内皮功能与CSF的发病机制存在密切关系。

Clinical features of coronary slow flow and its correlation with vascular endothelial function

Objective To study the clinical features of coronary slow flow and its correlation with vascular en-dothelial function. Methods From Feb. 2014 to Jan. 2016, 80 cases of patients with coronary slow flow (CFS) con-firmed by coronary arteriongraphy were selected as the observation group, and 80 cases of patients without CSF and cor-onary artery stenosis were selected as the control group. The blood flow situation and endothelial function were com-pared between the two groups. The level of nitric oxide and endothelin-1 were also determined to analyze the correlation between CSF and vascular endothelial function. Results The difference in rates of smoking was statistically significant between the both groups (18% in control group vs 37% in observation group, P<0.05). The red cell distribution width (RDW), high-sensitivity C-reactive protein (hs-CRP), nitric oxide (NO) and endothelin-1 (ET-1) also showed statistical-ly significant differences between the two groups (P<0.05), (12.8 ± 0.5)%, (1.4 ± 0.5) mg/L, (35.2 ± 11.5)μmol/L, (17.4 ± 3.6) ng/L in the observation group vs (13.5.±0.9)%, (2.2±0.8) mg/L, (48.3±13.2)μmol/L, (15.1±2.4) ng/L in the control group, respectively. Multivariate logistic regression analysis showed that smoking (OR=5.469, P=0.000), RDW (OR=1.623, P=0.012), hs-CRP (OR=2.584, P=0.000), NO (OR=1.437, P=0.000), and ET-1 (OR=1.646, P=0.000) were the in-dependent risk factors of CSF. Conclusion Smoking, elevated levels of RDW and hs-CRP may play a role in the patho-physiology of CSF, and vascular endothelial function is closely related to the pathogenesis of CSF.