【摘要】 目的通过测定冠状动脉慢血流(CSF)患者血浆中的一氧化氮(NO)和内皮素-1(ET-1)的变化,探讨CSF的发病机制与血管内皮功能损伤的关系。方法选择经冠状动脉造影(CAG)诊断为无管腔狭窄及无慢血流者85例(对照组),CAG示CSF者85例(慢血流组),以及CAG示冠状动脉有意义狭窄者85例(狭窄组)。采用校正的TIMI血流分级(CTFC)方法评价冠状动脉血流速度。分别测定3组患者血浆中NO、ET-1的水平。结果慢血流组和狭窄组血浆ET-1均高于对照组,差异有统计学意义(P<0.05);慢血流组血浆ET-1低于狭窄组,差异有统计学有意义(P<0.01)。慢血流组和狭窄组血浆NO均低于对照组,差异有统计学意义(P<0.01);慢血流组血浆NO高于狭窄组,差异有统计学意义(P<0.01)。慢血流组和狭窄组低密度脂蛋白胆固醇、血尿酸水平和吸烟比例均高于对照组,对照组高密度脂蛋白胆固醇高于慢血流组和狭窄组,差异均有统计学意义(P<0.05)。经多元Logistic回归分析表明,ET-1升高、NO降低、低密度脂蛋白胆固醇升高、高密度脂蛋白胆固醇降低、血尿酸升高以及吸烟为CSF的独立危险因素。结论血尿酸和低密度脂蛋白胆固醇升高,高密度脂蛋白胆固醇降低以及吸烟可能参与CSF的病理生理发生过程,内皮功能损伤与CSF的发病机制有密切关系。更多还原

【Abstract】 Objective To investigate the relationship between endothelial dysfunction and pathogeny of coronary slow flow(CSF) by observing the plasma nitric oxide(NO) and endothelin-1(ET-1)levels of CSF patients.Methods Eighty-five patients with normal coronary flow and angiographically normal coronary arteries were enrolled as control group,and 85 patients with coronary slow flow angiographically were enrolled as CSF group.The stenosis group population consisted of 85 patients with coronary artery stenosis angiographically.Coronary flow patterns of the cases were assessed by corrected thrombolysis in myocardial infarction(TIMI) frame count(CTFC).The changes of plasma NO and ET-1 were measured respectively.Results Slow flow and stenosis group the plasma levels of ET-1 were higher than the control group,the difference was statistically significant(P<0.05);slow flow of plasma ET-1 below the stenosis group,the difference was statistically significant(P<0.01).Slow flow and stenosis group the plasma levels of NO were lower than the control group,the difference was statistically significant(P<0.01);slow flow of plasma NO is higher than that of stenosis group,the difference was statistically significant(P<0.01).Slow flow and stenosis group and low density lipoprotein cholesterol,blood uric acid level and the proportion of smokers was higher than that of the control group,the control group was higher than that of high density lipoprotein slow blood flow and stenosis group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that,ET-1 increased,NO decreased,increased,low density lipoprotein,high density lipoprotein,reduce blood uric acid increased,and smoking as independent risk factors for CSF.Conclusion High uric acid level,high LDL-C level,low HDL-C level and smoking play an important role in the pathogenesis of CSF.A significant correlation between CSF and impaired endothelial function was found in this study.更多还原