CAJ | 학술논문

目的：通过常规冠脉造影，运用数字跟踪技术软件测定冠脉造影正常患者冠脉血流储备（ Coro-nary Flow Reserve，CFR），冠脉内注射乙酰胆碱（Acetylcholine，Ach）并检测高敏C反应蛋白（ high Sensitivi-ty，hsCRP）含量评价内皮功能，观察不同危险因素组别间CFR与内皮功能的变化，探讨其变化意义。方法：118拟诊冠心病患者，平均年龄61±11（岁），按不同危险因素分成高血压、高胆固醇血症、肥胖、吸烟、2型糖尿病及≥2危险因素组，另设对照组24例，平均年龄56±12．9（岁）。常规冠脉造影正常，运用数字跟踪技术软件测定患者CFR，冠脉内注射Ach，抽血检测hsCRP含量，根据Ach阳性率、hsCRP含量评价内皮功能，观察不同组别间CFR、Ach阳性率、hsCRP的变化。结果：高血压、吸烟组及≥2危险因素组CFR低于对照组，Ach阳性率及hsCRP水平高于对照组；肥胖组、糖尿病组及高胆固醇血症组CFR低于对照组，Ach阳性率及hsCRP水平高于对照组，但无显著差异；糖尿病组hsCRP水平高于对照组。结论：数字跟踪技术软件可方便测定CFR；具有不同危险因素人群存在冠脉血流储备降低且伴有内皮功能异常。
목적：통과상규관맥조영，운용수자근종기술연건측정관맥조영정상환자관맥혈류저비（ Coro-nary Flow Reserve，CFR），관맥내주사을선담감（Acetylcholine，Ach）병검측고민C반응단백（ high Sensitivi-ty，hsCRP）함량평개내피공능，관찰불동위험인소조별간CFR여내피공능적변화，탐토기변화의의。방법：118의진관심병환자，평균년령61±11（세），안불동위험인소분성고혈압、고담고순혈증、비반、흡연、2형당뇨병급≥2위험인소조，령설대조조24례，평균년령56±12．9（세）。상규관맥조영정상，운용수자근종기술연건측정환자CFR，관맥내주사Ach，추혈검측hsCRP함량，근거Ach양성솔、hsCRP함량평개내피공능，관찰불동조별간CFR、Ach양성솔、hsCRP적변화。결과：고혈압、흡연조급≥2위험인소조CFR저우대조조，Ach양성솔급hsCRP수평고우대조조；비반조、당뇨병조급고담고순혈증조CFR저우대조조，Ach양성솔급hsCRP수평고우대조조，단무현저차이；당뇨병조hsCRP수평고우대조조。결론：수자근종기술연건가방편측정CFR；구유불동위험인소인군존재관맥혈류저비강저차반유내피공능이상。
Objective Coronary Flow Reserve ( CFR ) of patients with normal coronary arteriograms were measured by the use of angiographic digital tracking and endothelial function were evaluated by intracoronary acetyl -choline(Ach) test and high-sensitivity C-reactive protein (hsCRP) levels.The change of CFR and endothelial function in patients with different risk factors were observed and analysed .Methods In selected 118 cases ( The mean age 61 ±11 years old ) with suspected coronary artery disease were divided into 6 groups according to different risk factors:hypertension , hypercholesterolemia , obesity , smoking , type 2 diabetes mellitus and ≥2 risk factors groups while 24 healthy subjects ( The mean age 56 ±12 years old ) as matched .CFR of patients with normal coro-nary arteriograms were measured by the use of angiographic digital tracking and endothelial function were evaluated by intracoronary Ach test and hsCRP levels .The change of CFR , positive rates of Ach test , hsCRP levels were ob-served and analysed .Results CFR in group of hypertension , smoking and≥2 risk factors were lower and positive rates of Ach test ,hsCRP levels were higher than those of the control group .CFR in group of hypercholesterolemia , Obesity , Type 2 Diabetes Mellitus groups were lower and positive rates of Ach test were higher than those of the control group but there were no significant differences between them .hsCRP levels of Type 2 Diabetes Mellitus group were higher than those of the control group .Conclusion Angiography digital tracking method can be easily used in measuring CFR .Lower CFR and endothelial dysfunction in people with different risk factors were observed in this reaserch .