影响冠状动脉造影患者冠状动脉慢血流的相关危险因素

目的分析影响冠状动脉造影(CAG)患者冠状动脉慢血流(CSF)的相关危险因素。方法回顾性分析我院423例行CAG检查且冠状动脉无明显狭窄、造影过程中保持窦性心律者的临床资料,根据CSF发生情况分为CSF组(n=230)与非CSF组(n=193)。比较两组性别、年龄、病史、白细胞计数(WBC)、红细胞压积(HCT)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、血肌酐(Scr)、血尿酸(SUA)、同型半胱氨酸(Hcy)、一氧化氮(NO)、内皮素-1(ET-1)差异,并分析影响CAG患者CSF发生的相关危险因素。结果两组性别、年龄、高血压病史、糖尿病病史、高脂血症病史、吸烟史、饮酒史、WBC、TG、TC、Scr、ET-1水平比较,差异无统计学意义(P>0.05);CSF组HCT、LDL-C、SUA、Hcy水平均高于非CSF组(P<0.05),而HDL-C、NO水平则低于非CSF组(P<0.05)。经Logistic回归分析发现,HCT、SUA、Hcy为影响CAG患者CSF发生的独立危险因素(OR=2.776、2.447、2.214,P<0.05),HDL-C、NO则为独立保护因素(OR=0.440、0.423,P<0.05)。结论高血液黏度、血管内皮损伤、脂代谢紊乱是导致CSF发生的危险因素,临床应予以相应防控措施,以降低CSF发生率。

Related Risk Factors Affecting Coronary Slow Flow in Patients with Coronary Arteriography

Objective To analyze the related risk factors that affect coronary slow flow (CSF) in patients with coronary arteriography (CAG). Methods The clinical data of 423 patients who underwent CAG examination without coronary stenosis and maintained sinus rhythm during angiography were retrospectively analyzed. The patients were divided into CSF group ( n =230) and non-CSF group ( n =193) according to the CSF status. The gender, age, medical history, white blood cell count (WBC), hematocrit (HCT), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), serum creatinine (Scr), serum uric acid (SUA), homocysteine (Hcy), nitric oxide (NO) and endothelin-1 (ET-1) were compared between the two groups, and the related risk factors affecting CSF occurrence in CAG patients were analyzed. Results There were no significant differences in gender, age, history of hypertension, history of diabetes, history of hyperlipidemia, history of smoking, history of drinking, and levels of WBC, TG, TC, Scr and ET-1 ( P >0.05). The levels of HCT, LDL-C, SUA and Hcy in CSF group were higher than those in non-CSF group ( P <0.05) while the levels of HDL-C and NO were lower than those in non-CSF group ( P <0.05). Logistic regression analysis showed that HCT, SUA and Hcy were independent risk factors for CSF occurrence in patients with CAG ( OR=2.776, 2.447, 2.214, P <0.05), and HDL-C and NO were independent protective factors ( OR=0.440, 0.423, P <0.05). Conclusion High blood viscosity, vascular endothelial injury and lipid metabolism disorder are risk factors for CSF occurrence. Corresponding prevention and control measures should be taken in clinical practice to reduce the incidence rate of CSF.