大动脉弹性与冠状动脉粥样硬化严重程度的关系

Relationship between large artery elasticity and coronary atherosclerosis.

目的 探讨大动脉弹性与冠状动脉粥样硬化严重程度的关系。方法 对连续入选的114例患者行冠状动脉造影检查，并行升主动脉和股动脉压力波形同步描记，测量计算并评价升主动脉弹性功能的参数：脉搏波传导速度（PWV）、中心动脉反射波增压（AUG）和反射波 增强指数（AJ）。冠状动脉病变的严重程度用冠状动脉病变的血管支数表示。结果 冠状动脉造影异常59例，logPWV、AI显著高于冠状动脉造影正常组[PWV（0．938±0．161比0．851±0．106，P=0．007）、AI（13．41±14．37比7．46±15．10，P=0．034）]。单因素分析提示，PWV可能是冠心病发病的危险因素（OR=1．306，P=0．005）。校正年龄、吸烟、体质指数、血糖、总胆固醇、甘油三酯、收缩压、舒张压、脉压等冠心病发病危险因素后，logistic回归分析显示，PWV是冠心病发病的一项独立预测指标（OR=1．361，P=0．008）。多因素分析显示，PWV随冠状动脉病变严重程度增加而增加。结论 动脉弹性功能与冠心病发病及病变程度密切相关，PWV是反映大动脉弹性的较好参数，对冠心病防治有广泛应用前景。

Objective To evaluate the relationship between large artery elasticity and coronary atherosclerosis. Methods 114 consecutively enrolled patients underwent coronary angiography and ascending aortic and femoral artery pressure were recorded. Aortic Pulse Wave Velocity （ PWV ） central aortic pressure augmentation （ AUG） and augmentation index （AI） were measured. The severity of coronary heart disease was shown by the number of diseased arteries. Results Fifty nine patients with coronary artery disease were diagnosed by coronary angiography, with the logPWV values of （0.938 ±0. 161 ） ,significantly higher than that in the control group [ （0. 851 ±0. 106） ,P =0. 007 ] and AI values of （ 13.41 ± 14.37 ）, significantly higher than that in the control group [ （ 7.46 ± 15.10 ）, P = 0.034 ]. In univariate analysis, a higher PWV was associated with an increased risk for coronary artery disease（ OR = 1. 306 ,P =0. 005 ）. After being adjusted in age, body index, smoking, cholesterol, PP, DBP and SBP by logistic regression model,the association between PWV and coronary artery disease risk remained significant （ OR = 1. 361 ; P = 0. 008 ）. In a multivariate analysis, PWV was the best predictor for the severity of coronary artery disease. Conclusion PWV is the parameter reflecting large artery elasticity and closely related to severity of coronary artery disease, and may be a marker of cardiovascular risk,instructing early intervention.