摘要
目的探讨内皮依赖血管舒张功能和动脉弹性在冠状动脉病变不同程度患者中的差异。方法对心内科96例住院患者进行冠状动脉造影,并通过Gensini评分系统对冠心病患者冠状动脉病变进行评分,根据冠状动脉病变程度的不同,将患者分为冠状动脉正常组22例、冠状动脉早期病变组20例、冠心病轻度病变组19例、冠心病重度病变组35例;并采用高分辨率血管超声法检测患者肱动脉血流介导的内皮依赖性血管舒张功能;应用动脉弹性功能检测仪测定受试者的大动脉弹性指数和小动脉弹性指数。结果冠状动脉正常组、冠状动脉早期病变组、冠心病轻度病变组、冠心病重度病变组内皮依赖性血管舒张功能分别为9.79%±4.33%、8.21%±4.38%、5.34%±3.67%和4.59%±2.20%,大动脉弹性指数分别为917.3±315.8、870.7±266.9、849.8±346.7、795.6±134.6μL/Pa,小动脉弹性指数分别为5.05±2.01、4.68±1.43、4.02±2.10、3.23±1.81mL/Pa。内皮依赖性血管舒张功能及小动脉弹性指数在4组间比较,差异有显著性(P<0.05);大动脉弹性指数4组间比较,差异无统计学意义。结论随着冠状动脉病变的逐渐加重,患者小动脉弹性指数和血管内皮依赖的血管舒张功能,即患者的内皮功能亦逐渐加重,提示小动脉弹性指数和血管内皮依赖的血管舒张功能可作为一种评价冠状动脉病变程度的新指标。
Aim To investigate difference of endothelium-dependent vasodilation or arterial elasticity in patients with different grade of coronary artery pathologic change. Methods Ninety six subjects were divided into four groups by results of coronary angiography： 22 cases of normal coronary artery, 20 cases of early coronary artery lesions, 54 cases of coronary heart disease; coronary heart disease group was divided into two groups by the Gemini scoring： 19 cases of gentle coronary artery lesions （Gemini score 〈 20）, 35 eases of severe coronary artery lesions （Gemini score ≥ 20）. Flow-mediated dilation in the braehial artery was evaluated by ultrasound Doppler flow method. They were also underwent a noninvasive assessment of large artery and small artery elasticity index by using pulse wave analysis. Results The flow-mediated dilation of normal coronary artery, early coronary artery lesions, gentle coronary artery lesions, severe coronary artery lesions were 9.79% ± 4.33%, 8.21% ± 4.38 %, 5.34% ± 3.67 % and 4.59 % ± 2.20% respectively. The large artery elasticity index of the four groups were 917.3 ±315.8, 870.7±266.9, 849.8±346.7, 795.6±134.6 μL/Pa, respectively. The small artery elasticity index of the four groups were 5.05±2.01, 4.68±1.43, 4.02±2.10, 3.23±1.81 mL/Pa respectively. The difference among the four groups was significant on flow-mediated dilation and small artery elasticity index （ P 〈 0.05）. However, there was no significant difference among the four groups on large artery elasticity index. Conclusions Following the increase of grade of coronary artery pathologic change, the impaired endothelium-dependent vasodilation and reduced small artery elasticity index were worsened. The present study suggested that the measurement of flow-mediated dilation or small artery elasticity index might be used as a novel index for the determination of the pathological change grade of coronary artery.
出处
《中国动脉硬化杂志》
CAS
CSCD
2007年第4期307-310,共4页
Chinese Journal of Arteriosclerosis
