冠心病患者升主动脉功能初步检测

A research on the aortic distensibility in patients with coronary artery disease

目的:观察冠心病(CHD)患者升主动脉功能的改变,探索无创检测动脉粥样硬化的方法。方法:采用冠状动脉造影术筛选的方法,将56例患者分为两组:CHD组30例,男16例,女14例;对照组26例,均为无冠状动脉狭窄或未达到指标的患者,男15例,女11例。对56例经选择性冠状动脉造影检查的患者行升主动脉弹性检测。用超声心动图在升主动脉同一点处测量收缩期内径(Ds)和舒张期内径(Dd),用公式计算出升主动脉僵硬度和扩张性。多普勒组织成像(DTI)模式下获取升主动脉前壁运动频谱,分别测量S波、E波和A波的速度(Sao,Eao,Aao)。结果:①CHD组与对照组比较,升主动脉扩张性为(13.02±7.96)×10-4cm2/dynvs(36.78±18.83)×10-4cm2/dyn,P=0.003;僵硬度指数为(23.20±11.06)vs(15.23±7.32),P=0.017,差异均有显著性意义。②CHD组与对照组比较,DTI模式下升主动脉前壁运动频谱结果:Sao为(0.08±0.01)vs(0.10±0.02),P=0.011;Eao为(0.05±0.01)vs(0.07±0.02),P=0.026;Aao为(0.08±0.01)vs(0.08±0.02),P>0.05,差异均有显著性意义。③Sao与升主动脉扩张性呈正相关(r=0.73,P=0.03);而与僵硬度指数呈负相关(r=-0.68,P=0.03)。结论:升主动脉前壁S波速度可直接用DTI技术反映升主动脉弹性,S波速度与升主动脉扩张性及僵硬度密切相关。以上指标均可反映CHD患者升主动脉功能的改变。

Objective ：To observe the changes of aortic distensibility in patients with Coronary atherosclerosis heart disease （CHD）. Methods：The subjects were divided by coronary arteriography into two groups as coronary artery disease and normal group. The 56 patients were examined internal aortic systolic and diastolic diameter by ultrasound. Ascending aortic stiffness index beta （13） and distensibility coefficient （D） were calculated using formulas. Aortic upper wall tissue velocities （aortic S ,E, A,m/s）were measured with Doppler Tissue Imaging （DTI）. Results ①Ascending aortic distensibility coefficient （D） [（13.02 ±7.96） × 10 ^-4 cm^2/dyn vs （36. 78 ± 18.83） ×10^-4cm^2/dyn,P =0. 003] and aortic stiffness （13） [ （23.20 ± 11.06） vs （ 15.23±7.32） ,P =0.017] was significantly different between CHD group and the control group. ②Aortic upper wall tissue velocities in DTI： Sao[ （0.08 ±0. 01 ）vs （0. 10 ±0.02）,P = 0.011 ] ;Eao[ （0.05 ±0.01） vs （0.07 ±0.02） ,P =0. 026] ;Aao[ （0.08 ±0. 01）vs （0.08 ＋0.02） ,P 〉 0.05]. Sao and Eao was significantly different between CHD group and the control group, but Aao has not significant different. ③Sao positively correlated with ascending aortic distensibility coefficient （D） （r = 0.73,P=0.03） ,and negatively correlated with aortic stiffness （β）（r = -0.68,P=0.03）. Conclusion： Elastic properties of the aorta can directly be assessed by measuring the movements in the upper wall of the aorta with DTI. Reduced aortic S-velocity is signifieantly correlated with Ascending aortic distensibility coefficient （D） and stiffness index beta （β）, which are important factors in assessing the changes of the aortic distensibility.