冠心病患者甲襞微循环、血液流变性、血脂及血糖的变化

Changes of nailfold microcirculation,hemodynamics and serum lipids and glucose in patients with coronary artery disease

目的:通过观察冠心病(CHD)患者的甲襞微循环、血液流变学指标、血脂及血糖的变化,为及早诊断、治疗及预后判断提供依据。方法:确诊为CHD的患者156例进行甲襞微循环、血液流变学、血脂及血糖等进行检测。结果:与50例正常人相比较,CHD患者甲襞毛细血管数减少、交叉、畸形管襻增多,输入支变细、输出支和乳头下静脉丛扩张、血流速度减慢伴红细胞聚集;全血黏度、血浆黏度、红细胞压积、血沉、纤维蛋白原、血小板黏附性和聚集性增加;总胆固醇、三酰甘油、血糖增高,高密度脂蛋白胆固醇降低;并发有高血压病、糖尿病、高脂血症的CHD患者的甲襞微循环、血液流变性明显异常。结论:CHD患者的甲襞微循环、血液流变性、血脂、血糖明显异常;并发有高血压病、糖尿病、高血脂症的CHD患者甲襞微循环、血液流变性异常更为严重。

AIM： To observe the changes of nailfold microcirculation, hemodynainics, and serum lipid and glucose in patients with coronary artery disease （CAD） for early diagnosis, treatment and prognosis. METHODS： Nailfold Inicrocirculation, heinodynainic and seruin lipid and glucose changes were examined in 156 patients with CAD. RESULTS： Compared with those in the control （n =50） , density of nailfold vasoloops, diameters of arterial liinb of vasoloops and blood flow velocity decreased, whereas the intersection and deformity vasoloops, diameters of venous limb of vasoloops and subpapillary venous plexa density increased. Erythrocytes aggregated greatly and whole blood viscosity, plasma viscosity, ESR, fibrinogen, blood platelet adhesion and aggregation, total cholesterol, triglyceride and serum glucose levels were significantly higher, but the serum level of high-density lipoprotein cholesterol was significantly lower. Nailfold Inicroeirculation and heinodynainics were evidently abnormal in patients with eoinorbid conditions such as hypertension, diabetes, or/and hyperlipidemia. CONCLUSION： Nailfold Inicrocirculation, hemodynainics, and serum lipid and glucose in patients with CAD are clearly abnormal and the changes are more severe in CAD patients with comorbidiites such as hypertension, diabetes or/and hyperlipidemia.