CAJ | 학술논문

目的探讨冠心病患者的血管内皮功能改变及其与冠状动脉病变严重程度的关系.方法 73例拟行冠状动脉造影术的患者,根据冠状动脉造影结果将其分为冠心病组39例和非冠心病组34例.13例健康、无冠心病危险因素者作为对照组.运用高频线阵超声测定肱动脉流量介导的血管扩张作用指标流量介导血管扩张比(FMD)及硝酸酯介导的血管扩张作用指标硝酸酯介导血管扩张比(NTG-MD),评估患者的血管内皮功能状况,以探讨血管内皮功能与冠状动脉狭窄间的关系.结果冠心病组、非冠心病组和对照组的FMD分别为(4.81±2.33)%、(9.29±3.88)%和(13.58±1.80)%,3组间两两比较差异均有统计学意义(F值为48.012,P＜0.01);NTG-MD分别为(13.72±3.27)%、(15.64±2.65)%、(16.54±2.98)%,3组问差异有统计学意义(F值为6.015,P＜0.01),冠心病组与其余2组相比差异均有统计学意义(P均＜0.05).FMD与管径基础值、冠状动脉受累支数及冠状动脉最大狭窄程度呈负相关(r分别为-0.224、-0.316、-0.721,P分别为0.038、0.003和＜0.001).NTG-MD与管径基础值、冠状动脉受累支数及冠状动脉最大狭窄程度亦呈负相关(r分别为-0.483、-0.258、-0.372,P分别为＜0.001、0.027、0.001).多项逐步回归分析显示FMD与冠状动脉最大狭窄程度、管径基础值呈线性关系(r分别为-0.012、-0.022,P均＜0.001).NTG-MD与管径基础值及冠状动脉最大狭窄程度呈线性关系(r分别为-0.032、-0.0073.P均＜0.001).结论冠心病患者内皮损害程度与冠状动脉狭窄严重程度之间呈线性相关.
목적 탐토관심병환자적혈관내피공능개변급기여관상동맥병변엄중정도적관계.방법 73례의행관상동맥조영술적환자,근거관상동맥조영결과장기분위관심병조39례화비관심병조34례.13례건강、무관심병위험인소자작위대조조.운용고빈선진초성측정굉동맥류량개도적혈관확장작용지표류량개도혈관확장비(FMD)급초산지개도적혈관확장작용지표초산지개도혈관확장비(NTG-MD),평고환자적혈관내피공능상황,이탐토혈관내피공능여관상동맥협착간적관계.결과 관심병조、비관심병조화대조조적FMD분별위(4.81±2.33)%、(9.29±3.88)%화(13.58±1.80)%,3조간량량비교차이균유통계학의의(F치위48.012,P＜0.01);NTG-MD분별위(13.72±3.27)%、(15.64±2.65)%、(16.54±2.98)%,3조문차이유통계학의의(F치위6.015,P＜0.01),관심병조여기여2조상비차이균유통계학의의(P균＜0.05).FMD여관경기출치、관상동맥수루지수급관상동맥최대협착정도정부상관(r분별위-0.224、-0.316、-0.721,P분별위0.038、0.003화＜0.001).NTG-MD여관경기출치、관상동맥수루지수급관상동맥최대협착정도역정부상관(r분별위-0.483、-0.258、-0.372,P분별위＜0.001、0.027、0.001).다항축보회귀분석현시FMD여관상동맥최대협착정도、관경기출치정선성관계(r분별위-0.012、-0.022,P균＜0.001).NTG-MD여관경기출치급관상동맥최대협착정도정선성관계(r분별위-0.032、-0.0073.P균＜0.001).결론 관심병환자내피손해정도여관상동맥협착엄중정도지간정선성상관.
Objective To evaluate the relationship between vascular endothelial function of coronary heart disease and the severity of coronary artery disease(CHD).Methods 73 patients undergoing coronary angiography were divided into two groups:CHD group(n=39)and non-CHD group(n=34)according to the result of coronary angiography.13 healthy subjects without risk factor of CHD were chosen as normal control group.FMD and NTG-MD of endothelial-dependent and independent dilatation of brachial artery were measured by using of high frequency linear-array uhrasonography for assessment of the vascular endothelial function.and the relationship between the vascular endothelial function and the severity of coronary artery stenosis was analyzed.Results A significant difference was obtained in the FMD among the CHD group,non-CHD group and control group[(4.81±2.33)%vs.(9.29±3.88)%vs.(13.58±1.80)%,F=48.012,P＜0.01).Significant difference was shown in NTG.MD among the three groups[(13.72±3.27)%vs.(15.64±2.65)%vs.(16.54±2.98)%,F=6.015,P＜0.01]and significant difference was shown between CHD group and the other two group(P＜0.05).The FMD was negatively correlated with the basdine value of the brachial artery.tlle number of stenotic coronary ateries and the severity of coronary artery stenosis(r=-0.224,-0,316,-0.721,P=0.038,0.003 and ＜0.001).NTG-MD was also negatively correlated with the baseline value of the brachial artery,the number of stenotic coronary arteries and the severity of coronary artery stenosis(r=-0.483,-0.258,-0.372,P＜0.001,0.027,0.001).Stepwise regression analysis displayed a linear relationship between FMD and the severity of coronary artery stenosis,the baseline value of the brachial artery(r=-0.012,-0.022,P＜0.001).NTG-MD was linearly related to the baseline value ofthe brachial artery and the severity of coronary artery stenosis(r=-0.032,-0.0073,P＜0.001).Conclusion The degree of damage of endothelial function of coronary heart disease is linearly correlated with severity of coronary arteIT stenosis.