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目的 :检测心绞痛患者心脏局部血管紧张素Ⅱ (AngⅡ )的浓度 ,选择性冠状动脉造影评估冠状动脉病变的危险分数 ,分析心脏局部血管紧张素Ⅱ (AngⅡ )与危险分数的相关性。方法 :37例心绞痛患者均经冠状动脉造影证实有明显冠状动脉狭窄 ;18例正常对照者经临床检查和选择性冠状动脉造影排除冠心病。在经皮冠状动脉介入手术中采集主动脉、冠状窦和外周血液标本 ,测定主动脉与冠状窦血液中AngⅡ的浓度 ,计算二者之间的差值 ,以此代表心脏局部产生的AngⅡ浓度 ,同时测定外周血中AngⅡ浓度。按照Califf介绍的危险分数评价选择性冠状动脉造影冠状动脉病变情况。结果 :心绞痛患者尤其是不稳定型心绞痛患者心脏局部和外周血中AngⅡ浓度均明显增高 (P <0 .0 1) ,心脏局部AngⅡ浓度与危险分数呈明显正相关 (P <0 .0 1) ,不稳定型心绞痛患者外周血AngⅡ浓度与危险分数呈明显正相关 (P <0 .0 5 ) ,稳定型心绞痛患者外周血AngⅡ浓度与危险分数无明显相关性。结论 :心脏局部AngⅡ浓度与冠状动脉病变危险分数密切相关 ,心脏局部AngⅡ可能在动脉粥样硬化和冠心病的发生发展中起重要作用。冠状动脉造影所见的冠状动脉病变结合检测心脏局部AngⅡ浓度 ,对更确切地评估冠状动脉病变的程度和判断冠心病患者的预后可能提供一些帮
Objective: To detect the concentration of angiotensin Ⅱ (Ang Ⅱ) in the heart of patients with angina pectoris, to evaluate the risk score of coronary artery disease by selective coronary angiography, and to analyze the correlation between local angiotensin Ⅱ (Ang Ⅱ) and risk score. Methods: Thirty-seven patients with angina pectoris had obvious coronary stenosis confirmed by coronary angiography. Coronary heart disease was excluded by clinical examination and selective coronary angiography in 18 normal controls. Aortic, coronary sinus and peripheral blood samples were collected during percutaneous coronary intervention to determine the concentration of Ang II in the aorta and coronary sinus blood. The difference between the two was calculated to represent the concentration of Ang II locally produced in the heart, Meanwhile, the concentration of Ang II in peripheral blood was measured. Selective coronary angiography of coronary lesions was evaluated according to the risk score introduced by Califf. Results: Ang Ⅱ concentration in heart and peripheral blood of patients with angina pectoris, especially in patients with unstable angina pectoris, was significantly increased (P <0.01), and local AngⅡ concentration was positively correlated with risk score (P <0.01) There was a significant positive correlation between Ang Ⅱ concentration and risk score in patients with unstable angina (P <0.05). There was no significant correlation between Ang Ⅱ concentration and risk score in patients with stable angina pectoris. CONCLUSION: AngⅡ concentration in heart is closely related to the risk of coronary artery disease. Local AngⅡ in heart may play an important role in the development of atherosclerosis and coronary heart disease. Coronary angiography coronary artery disease combined with the detection of local Ang Ⅱ concentration in the heart, to more accurately assess the extent of coronary lesions and to determine the prognosis of patients with coronary heart disease may provide some help