摘要
目的对比观察冠心病患者外周动脉反应性充血指数(reactive hyperemia index,RHI)和循环内皮祖细胞(endothelial progenitor cells,EPCs)水平,探讨RHI在冠心病患者血管内皮功能评价中的应用价值,为冠心病病情评估、调脂治疗评价、预后评估提供临床手段。方法选取2015年9-12月在第三军医大学新桥医院全军心血管病研究所住院患者195例,其中男性115例,女性80例;平均年龄61岁,中位年龄60岁。根据冠状动脉造影结果分为冠心病组(129例)及对照组(66例)。冠心病组进一步按照心脏外科与介入治疗狭窄冠脉协同研究积分法(SYNTAX积分)分为低积分组、中积分组和高积分组。采用流式细胞术检测外周血中的EPCs,并使用外周血管内皮张力计Endo-PAT2000检测受试人群动脉RHI,比较RHI和EPCs评价冠心病危险因素的特异度和灵敏度。结果与对照组比较,冠心病组外周血中EPCs数量显著减少,RHI显著降低(P<0.05),外周血EPCs水平与动脉RHI呈显著正相关趋势(r=0.269,P<0.05)。各冠心病亚组中,中、高积分组较低积分组EPCs水平与RHI显著降低(P<0.05)。糖尿病、高血压病和吸烟可影响RHI和循环EPCs水平(P<0.05),糖尿病是影响RHI的主效应因素。结论 RHI因其操作便利、无创,可直观反映血管内皮功能以及可靠的灵敏度和准确性,在评价冠心病患者血管内皮功能方面较循环EPCs更有优势。
Objective To apply reactive hyperemia index （RHI） of peripheral arteries and circulating endothelial progenitor cells （EPCs） proportion in the patients with coronary heart diseases （CHD） , and determine the application value of the index in the evaluation of endothelial function in order to provide clinical measure for disease assessment, anti-lipid therapy evaluation and prognosis. Methods A total of 195 patients admitted in the institute of cardiovascular diseases of Xinqiao Hospital from September to December 2015 were enrolled in this study. They were 115 males and 80 females, at an average age of 61 and median age of 60. According to the results of coronary angiography, the 195 patients were divided into the CHD group （n = 129） and control group （n=66）. Then CHD group was subdivided into low-, moderate- and high-risk subgroups based on Synergy between PCI with TAXUS and Cardiac Surgery （SYNTAX） Scoring System. The circulating EPCs was determined by flow cytometry and the RHI by noninvasive peripheral arterial tonometry （Endo-PAT 2000 ）. The specificity and sensitivity were compared between the index and the proportion of EPCs in evaluating risk factors of CHD. Results Compared with the control group, the proportion of circulating EPCs was significantly decreased, and RHI was lower in CHD group （ P 〈 0.05）. A positive correlation was observed between the proportion of ERPs and RHI （ r = 0. 269, P 〈 0.05 ）. In SYNTAX subgroups, the proportion of EPCs and RHI were obviously reduced in the moderate- and high-risk subgroups than the low-risk subgroup （P 〈 0.05 ）. Diabetes, hypertension and smoking may have influences on RHI and EPCs proportion （P 〈 0. 05）, and among them, diabetes contributed most. Conclusion RHI is superior to EPCs in noninvasion, easy to operation, and directly display endothelial function, as well as its reliable sensitivity and accuracy.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第19期2168-2173,共6页
Journal of Third Military Medical University
基金
科技部惠民计划项目(CSTC2015JCSF10005)~~
关键词
内皮功能
冠心病
内皮祖细胞
外周动脉反应性充血指数
endothelial function
coronary heart diseases
endothelial progenitor cells
reactivehyperemia index, peripheral arteries
