冠心病患者肱动脉内皮功能与血液中动脉粥样硬化危险因子的相关性分析

目的观察冠心病患者血内皮素（ET）、同型半胱氨酸（Hcy）、低密度脂蛋白（LDL）的水平，探讨这些危险因素之间相关性及相关程度。进一步研究这些危险因素与超声心动图检测的肱动脉血流介导的内皮依赖性血管舒张功能（FMD）之间的关系。方法研究对象共53例，所有受检者均接受冠状动脉造影（CAG）检查，测血压、血ET、Hcy、LDL，并用超声心动图检查FMD，行定量化处理。所有病例依据CAG结果分为冠心病组（n=35）和对照组（n=18）。结果冠心病组ET、Hcy、LDL、FMD与对照组相比明显升高（P〈0．01或0．05）。在冠心病组患者中，ET与Hcy呈正相关（r=0．490，P〈0．01）；ET与FMD呈负相关（r=-0．603，P〈0．01）；Hcy与FMD呈负相关（r=-0．376，P〈0．05）。应用Logistic回归分析ET、Hcy、LDL相关性，证实ET、Hcy、LDL是冠心病患者动脉粥样硬化的危险因素，冠心病患者动脉粥样硬化危险因素中以Hcy作用最强，其次是LDL。结论冠心病患者血科、Hcy、LDL、FMD明显异常：其巾血Hcy、LDL与冠心病关系最为密切。

Relationship between endothelial function and the serum risk factors of atherosclerosis in patients with coronary artery disease

Objective To study the relations between the three risk factors of coronary artery disease(CAD) endothelins(ET),homocysteine(Hcy) and low-density-lipoprotein(LDL) in serum;and further,to explore the relationship between these risk factors and the flow-mediated vasodilation(FMD) in the brachial artery.Methods According to their coronary angiography(CAG),the 53 subjects recruited were divided into CAD group(n=35) and control group(n=18).The examined indexes included blood pressure,ET,Hcy and LDL.FMD was examined by echocardiography.The results were then quantitatively processed.Results The values of ET,Hcy,LDL and FMD in CAD group were significantly higher than that in control group(P<0.01 or 0.05).In CAD group,there was positive correlation between ET and Hcy(r=0.490,P<0.01) and negative correlation between ET and FMD(r=-0.603,P<0.01) and that between Hcy and FMD(r=-0.376,P<(0.05).) Logistic study showed ET,Hcy and LDL were the risk factors of atherosclerosis(AS) in CAD group,with Hcy and LDL being the top remarkable ones.Conclusion CAD patients have significantly abnormal ET,Hcy,LDL and FMD;there is a good correlation between the high levels of Hcy and LDL and the incidence of CAD.