冠心病患者肱动脉内皮功能研究

目的本研究通过观察不同程度病变冠心病患者的肱动脉内径,探讨冠心病与肱动脉内皮功能的关系,以期对冠心病患者的诊断及治疗提供客观化,定量化指导。方法选取在行冠脉造影检查的冠心病患者106例,根据冠状动脉造影结果分为两组:造影正常组28例;冠心病组78例。通过超声检测肱动脉基础内经、加压后30、60s的内径值。结果冠心病组与造影正常组基本资料均数进行比较差异无统计学意义,多元Logistic回归分析显示:加压后30、60s的内径值与冠心病的危险分层相关。多元逐步回归分析示:加压后30s冠心病的危险分层中的单支、双支、多支病变均有相关性(P<0.05)。冠心病患者肱动脉三种状态下的平均血流速度与吸烟三级、三酰甘油、低密度脂蛋白呈正相关,肱动脉三种状态下的平均血流速度与高密度脂蛋白负相关。冠心病组与吸烟1、2级、载脂蛋白及高胆固醇相关分析无统计学意义。结论随着冠脉病变程度增加,动脉内皮功能损害的危险性亦增加;冠心病的病变程度越重吸烟级别、三酰甘油、低密度脂蛋白值越大,高密度脂蛋白越低;血管内皮功能的超声检测方法能在冠心病患者冠状动脉血管病变严重程度的判断方面有所帮助。

Study on Endothelial Function of Brachial Artery about Patient with Coronary Heart Disease

Objective By observing varying degrees of coronary heart disease in patients with braehial artery inside diameter, to explore the relation between coronary artery disease and braehial artery endothelial function,to provide objective and quantitative guidanee for the diagnosis and treatment of coronary heart disease. Methods Selected 106 ease of patients with coronary heart disease,who had been examinated by eoronary angiography, according to the results of coronary angiography, were divided into two groups ：28 patients as normal angiography group ; 78 patients as coronary heart disease group. To test the inside diameter of braehial artery about foundation,after 30 s, 60 s compression by uhrasonie testing. Results The difference between group of coronary heart disease and group of normal imaging was not significant. Logistie regression analysis showed that the value of the inside diameter after 30 s,60 s compression had correlation with the risk stratification of coronary heart disease. Multielement stepwise regression analysis showed that the single, double and multi-vessel disease in risk stratification of coronary heart disease after 30 s eompression had correlation（ P 〈 0.05 ）. The average velocity in the three states of braehial artery had positive correlation with three-rank smoking, triglyeerides, low density lipoprotein, had negative eorrelation with high density lipoprotein. The eorrelations between coronary heart disease group and 1,2 rank smoking, high cholesterol and apolipoprotein were not significant. Conclusion With the inerease in the degree of coronary artery disease, the risk of arterial endothelial dysfunction also inereased; with the aggravation of coronary heart disease, the level of smoking, triglyeerides,low density lipoprotein ineresed,the high density lipoprotein decreased; the uhrasonie testing of artery endothelial function was helpful to judge the severity of pathological changes in coronary artery of coronary artery disease.