冠状动脉造影正常患者血清内皮素-1与TIMI-FC的关系

Relationship between endothelin-1 levels and TIMI frame counts in patients with ST-T changes but normal coronary arteriogram

目的:探讨静息心电图呈ST-T改变而冠状动脉造影正常、心电图运动负荷试验阳性和阴性者的血流TIMI-FC值改变和与静息时的内皮素-1(ET-1)浓度的关系。方法:41例有静息时心电图ST-T改变,选择性冠状动脉造影检查结果阴性患者,根据负荷心电图结果将其分为:心电图运动负荷试验阳性组(阳性组,18例)和心电图运动负荷试验阴性组(阴性组,23例)。20例静息心电图正常、负荷心电图阴性的健康志愿者为对照组。采用酶联免疫吸附法(ELISA)测定ET-1浓度,以Judkins法进行多方位冠状动脉造影,测量TIMI-FC。结果:①阳性组ET-1浓度和TIMI-FC值较阴性组和对照组均增高(均P<0.01);阴性组和对照组间比较差异无统计学意义(P>0.05);②ET-1水平和最大的TIMI-FC值呈正相关,ET-1水平与△TIMI-FC值也呈正相关,且相关性更大。结论:在静息心电图ST-T改变而冠状动脉造影正常者中,心电图运动负荷试验阳性的患者存在内皮功能异常。△TIMI-FC在评价冠状动脉内皮功能异常的严重程度上有一定价值。

Objective：To investigate the relationship of endothelin-1 and TIMI frame counts （TIMI-FC） in patients with ST-T changes on electrocardiogram （ECG） but normal coronary arteriogram （CAG）. Method：There were 41 patients with ST-T changes in rest ECG but normal CAG who were divided into 2 groups according to the results of exercise ECG test （positive group, n= 18; negative group, n=23）. There were 20 cases as healthy control group. Their plasma endothelin-1 levels were measured before exercise test and CAG. Result：①The endothelin-1 levels and values of TIMI-FC in positive group were increased significantly compared with those in negative group and control group （P〈0.01）. No difference was found in the negative group when compared with the control group （P〉0.05）.②The endothelin-1 levels were associated with the highest TIMI-FC and ATIMI-FC. Conclusion：These data suggest that endothelial dysfunction is associated with ATIMI-FC in the patients with positive exercise ECG test who present ST-T changes in rest ECG but normal CAG.