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目的探讨冠状动脉慢血流(CSF)现象与血管内皮功能的相关性。方法选取2012年10月~2013年10月在济宁市第一人民医院心内科住院,经冠状动脉造影(CAG)证实为CSF且无冠状动脉狭窄、冠状动脉畸形及血栓形成的患者60例作为慢血流组,同时随机选取同期CAG证实血流正常且无冠状动脉狭窄、冠状动脉畸形及血栓形成的患者20例作为对照组。通过高分辨率多普勒超声仪测定两组患者的基础肱动脉内径(D0)、肱动脉内皮依赖血流量介导的舒张反应(FMD)及非内皮依赖的硝酸甘油介导的舒张反应(NID),以此反应两组患者的血管内皮功能。对慢血流组与对照组患者的性别、年龄、体质量指数(BMI)、吸烟比例、血脂、空腹血糖、血压、血管内皮功能指标进行组间比较和相关性分析。结果慢血流组与对照组在年龄、BMI、空腹血糖、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、舒张压水平等方面均无统计学差异;慢血流组吸烟比例(63%vs.25%)、收缩压水平〔(126±12)mm Hg vs.(119±13)mm Hg〕均高于对照组(P<0.05);慢血流组男性比例(78%vs.30%)显著高于对照组(P<0.01);慢血流组与对照组相比D0、NID无统计学差异;慢血流组FMD显著低于对照组〔(6.3±1.3)%vs.(10.2±1.9)%,P<0.01〕,其平均血流帧数与FMD呈明显负相关(r=-0.70,P<0.01)。结论冠状动脉慢血流现象与内皮功能紊乱有相关性。
Objective To investigate the relationship between the phenomenon of slow-flowing coronary artery (CSF) and the function of vascular endothelium. Methods From October 2012 to October 2013 in Jining First People’s Hospital, Department of Cardiology, hospitalized by coronary angiography (CAG) confirmed CSF and no coronary artery stenosis, coronary artery disease and thrombosis in 60 patients as a slow Blood flow group, while randomly selected the same period of CAG confirmed normal blood flow and no coronary artery stenosis, coronary artery disease and thrombosis in 20 patients as a control group. The basal brachial artery diameter (D0), brachial artery endothelium-dependent blood flow-mediated relaxation (FMD) and non-endothelium-dependent nitroglycerin-mediated vasodilation (NID) were measured by high resolution Doppler sonography ), In order to reflect the two groups of patients with vascular endothelial function. The comparison of sex, age, body mass index (BMI), smoking proportion, blood fat, fasting blood glucose, blood pressure and vascular endothelial function in slow blood flow group and control group were compared between groups and correlation analysis. Results There was no significant difference in age, BMI, fasting blood glucose, total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL- , Diastolic blood pressure and other aspects were not statistically different; smoking in the slow blood flow group (63% vs.25%), systolic blood pressure 〔(126 ± 12) mm Hg vs. (119 ± 13) mmHg〕 were high (P <0.05). The proportion of male in the slow blood flow group (78% vs. 30%) was significantly higher than that in the control group (P <0.01). There was no significant difference in D0 and NID between the slow blood flow group and the control group ; FMD in slow blood flow group was significantly lower than that in control group [(6.3 ± 1.3)% vs (10.2 ± 1.9)%, P <0.01], and the mean blood flow frame number was negatively correlated with FMD (r = -0.70, P <0.01). Conclusion The phenomenon of slow blood flow in coronary arteries has a correlation with endothelial dysfunction.