冠心病患者冠状动脉病变血管数与高敏C反应蛋白、颈动脉斑块分级和内皮功能的相关性

Correlations among hsCRP,carotid artery plaque scores and the number of stenosed coronary artery in patients with coronary heart disease

目的探讨冠心病患者冠状动脉病变血管数与高敏C反应蛋白(hsCRP)、内皮依赖血管舒张功能、颈动脉内膜中层厚度(IMT)和斑块积分的相关性。方法采用高分辨率血管超声法检测76例冠心病患者与30例非冠心病对照组肱动脉血流介导的内皮依赖性血管舒张功能(FMD)、颈动脉IMT及斑块积分;并检测患者血液中hsCRP水平,对冠心病患者进行冠状动脉造影,根据冠状动脉病变血管数将冠心病患者分为3组:单支病变组、双支病变组及三支病变组。结果冠心病患者的血浆hsCRP显著高于对照组,FMD在冠心病各亚组中明显降低,与对照组比较差异有统计学意义(均为P<0.05);IMT在冠心病组中明显增厚,与对照组比较差异有统计学意义(均为P<0.05);颈动脉斑块积分在冠心病各亚组间比较差异有统计学意义(P<0.05)。冠心病患者冠状动脉病变血管数与血浆hsCRP及斑块积分呈正相关,与FMD呈负相关。结论血浆hsCRP、FMD及颈动脉斑块积分的检测与冠心病患者冠状动脉病变支数相关。

Objective To investigate the correlations among hsCRP, flow-mediated dilation （FMD）, common carotid artery intima-media thickness （IMT） and plaque scores with the number of stenosed coronary artery in patients with coronary heart disease （CHD）. Methods Seventy-six patients with CHD and 30 normal controls were recruited for this study. FMD in brachial artery, IMT and arteriosclerotic plaques in carotid arteries were evaluated with B-mode uhrasonography in all subjects. Patients with CHD were divided into 1-vessel disease group, 2-vessels disease group and 3- vessels disease group according to the results of coronary angiography. Plasma hsCRP was measured before angiography. Results IMT and hsCRP were significantly higher in CHD group than in control group （both P 〈 0. 05 ）. FMD was significantly lower in CHD group than in control group （ P 〈 0. 05 ）. Both hsCRP and atherosclerosis plaque scores were positively correlated with the number of stenosed coronary artery in patients with CHD （r = 0. 64 and 0. 41 respectively, both P 〈 0. 05 ）. FMD was negatively correlated with the number of stenosed coronary artery in patients with CHD （ r = -0. 43, P 〈 0. 05 ）. Conclusions The present study suggests there exist correlations among hsCRP, FMD and atherosclerosis plaque scores in carotid artery and the number of stenosed coronary artery in patients with CHD.