冠状动脉病变与大动脉弹性的相关性研究

目的:将临床常用的血压测定和外周动脉超声技术相结合,研究冠状动脉(冠脉)病变与大动脉弹性的相关性。方法:对所有入选病例行冠脉造影(CAG)检查,用Gensini法行冠脉病变评分,并根据CAG结果分为冠心病(CHD)组和正常对照组。于CAG前或后进行双侧颈动脉和心脏彩色多普勒检查,并测量血压、血糖、血脂、身高和体重。结果:CHD组与正常对照组比较,反映动脉弹性的脉压(PP)、PP指数(PI)、颈总动脉平均管壁张力(CWS)差异有统计学意义(P<0.01);反映早期动脉粥样硬化(CAS)的颈总动脉内-中膜增厚与SBP、PP、PI正相关,与CWS负相关,且与CWS及SBP的相关程度最高(标准回归系数为-0.799和0.392);反映冠脉AS程度的冠脉评分与PI、PP正相关,与CWS负相关,且与CWS和PP的相关程度最高(标准回归系数为-0.462和0.236)。结论:AS病变可致动脉弹性下降;早期AS与中央动脉弹性下降有关;冠脉硬化病变及其病变程度与颈动脉弹性密切相关。

Relationship between blood pressure and coronary atherosclerosis

Objective:To evaluate the correlation between atherosclerosis and blood pressure by studying large arterial distensibility function in patients with coronary heart disease. Methods:All patients were undergone coronary angiography and divided into two groups: normal coronary group and coronary heart disease group. Gensini's coronary angiography score was calculated to quantify the extent of coronary artery atherosclerosis. Blood pressure and ultrasonograph for carotid artery and heart were examined. Result:Levels of PP, PI, and mean circumferential wall stress(CWS) were significantly higher in coronary heart disease group than those in normal coronary group. Gensini's coronary angiography score was positively associated with PP and PI, and was negatively associated with CWS. Stepwise analysis revealed that CWS and PP were significantly associated with coronary angiography score. Conclusion:Coronary atherosclerosis is significantly relative to central artery distensibility.