肱动脉内皮功能对老年冠心病患者的预测价值

The value of endothelial function of brachial artery in predicting coronary artery disease in elderly patients

目的探讨肱动脉内皮功能对老年冠心病患者的预测价值。方法测定98例冠心病患者及37例对照者肱动脉内皮依赖血管舒张功能（FMD）及非内皮依赖血管舒张功能（NMD），根据冠脉造影结果将患者分为冠脉病变〈50％，50％～75％，〉75％病变组和冠脉病变0、1、2、3支病变组，以比较老年冠心病患者冠脉病变程度、范围与肱动脉FMD及NMD的相关性，进一步探讨肱动脉内皮功能对老年冠心病患者的预测价值。结果冠心病组肱动脉FMD及NMD均较对照组显著降低；FMD及NMD减低均与冠状动脉病变相关（r=-0．54，-0．52，均P〈0．01），都与冠状动脉病变程度及范围呈弱相关性（P〈0．01）；FMD、NMD均可作为评估冠状动脉病变的独立因素（OR值分别为0．81、0．82），FMD和NMD对诊断冠心病有意义（P〈0．05）。结论血管内皮功能对老年冠心病患者有一定的预测价值。

Objective To evaluate the value predicting coronary artery disease in elderly patients. of endothelial function of brachial artery in Methods Flow-mediated vasodilation （FMD） and nitroglycerin mediated dilation （NMD） were measured by high-frequency ultrasound in 98 patients with coronary artery disease and 37 controls. All the subjects were diagnosed by coronary arteriography. They were divided into coronary artery blockages 〈 50% subgroup, 50%-75% subgroup, 〉75% subgroup or coronary blockages in 0, 1, 2, 3 branch （es） subgroups. The correlations between FMD or NMD and the pathological extent or branches of coronary artery were studied and the predictive value of FMD and NMD were analyzed with ROC curve. Results In eoronary artery disease group, FMD and NMD were significantly decreased as compared with the control group. They were closely related with coronary artery disease （r=：- 0.54, -0.52, P〈 0.01）, and were weakly correlated with severity and range of coronary arterial lesion （P〈20.01）. With ROC curve analysis, FMD and NMD could be used to predict coronary artery disease. Conclusions Endothelial function can be used as an index to predict coronary artery disease.