X综合征病人的内皮功能失常及C反应蛋白的增高

Endothelial Dysfunction and Elevation of C-reactive Protein in Syndrome X Patients

目的 研究X综合征病人和慢性稳定性心绞痛病人的血管内皮功能的差异及是否伴有炎症标记物C反应蛋白 (CRP)的增高。方法 应用高分辨多谱勒超声仪研究 12例X综合征病人 ,48例慢性稳定性心绞痛病人及11例对照组的肱动脉内皮依赖的血流量介导的扩张反应 (FMD) ,并采用酶标记免疫检测法 (ELIMA)测量患者血中的CRP浓度。结果 内皮依赖的血流量介导的扩张反应在X综合征病人和慢性稳定性心绞痛病人无显著差异 ,但较对照组显著降低 (FMD % :4.15± 2 .32 ;4.33± 3 .13VS 7.5 8± 2 .39,P <0 .0 5 ) ,X综合征病人的内皮独立的硝酸甘油诱导的扩张反应和对照组无显著差异但显著高于慢性稳定心绞痛病人 (GTN -MD % :15± 2 .32 ;2 1.76± 8.88VS 11.6 3± 3 .77,P <0 .0 5 ) ,虽然X综合征的CRP略高于冠心病组 ,但差异无显著性 ,均显著高于对照组 (1.47± 0 .49mg/l;1.17± 0 .93mg/lVS 0 .6 5± 0 .2 9mg/l,P <0 .0 5 )。结论 和慢性稳定性心绞痛病人一样 ,X综合征病人不仅存在系统性的内皮功能失常亦存在导致内皮功能失常的致动脉粥样硬化的慢性炎症反应 。

Objective To investigate the difference of endothelial function and serum C-reactive protein in syndrome X and chronic stable angina patients.Methods The endotheliun-dependent flow-mediated dilatation (FMD) and endotheliun-independent glyceryl trinitrate-mediated dilatation(GTN-MD)were assessed in the right brachial artery in 12 cases of syndrome X,48 cases of chronic stable angina patients and 11 controls by high-resolution echocardiography. Enzyme-labled immunometric assay was used to analyse C-reactive protein.Results Endothelium-dependent flow-mediated dilatation had no significant difference between syndrome X and chronic stable angina patients, but it was significant lower than that in the control group(FMD%:4.15±2.32;4.33±3.13 VS 7.58±2.39, P <0.05).However,endothelium-independent grycerl trinitrate-mediated dilatation was not significantly different in syndrome X group with that in the control group,and more marked in chronic stable angina group(GTN-MD%:15±2.32;21.76±8.88 VS 11.63±3.77, P <0.05).CRP was similar in syndrome X and chronic stable angina patients,by contrast they were significantly higher than that in control group (1.47±0.49mg/l;1.17±0.93mg/l VS 0.65±0.29mg/l, P <0.05).Conclusion As in chronic stable angina patients,in syndrome X patients not only systematic endothelial dysfunction exists,but also the atherogenic inflammation which leads to endothelial dysfunction. However,smooth muscle cell function is not impaired.