内皮舒张功能与冠状动脉病变程度及中医证型的相关性研究

Relevant Research of Endothelial Relaxing Function and Degree of Coronary Artery Lesions and TCM Syndrome Types

目的探讨冠状动脉粥样硬化性心脏病(CHD)患者内皮舒张功能改变与冠状动脉病变程度、中医证型之间的相关性。方法收集合格CHD患者328例,使用数字减影心血管造影系统,以Judkins法观察冠状动脉病变程度;使用彩色超声诊断仪检测肱动脉内皮舒张功能,进而分析内皮舒张功能与冠状动脉病变程度、中医证型之间的相关性。结果内皮舒张功能与各中医证型之间的相关性:流量介导的血管扩张(FMD)和硝酸甘油介导的血管扩张(GNT)功能在CHD痰瘀相兼证患者中受损最重,其次为痰浊证、血瘀证,非痰非瘀证受损较轻,血瘀证、痰浊证、痰瘀相兼证与非痰非瘀证比较差异有统计学意义(P<0.05,P<0.01)。内皮舒张功能与冠状动脉病变程度的相关性:随着冠脉狭窄程度加重,FMD和GNT均逐渐降低;随着冠脉病变支数的增加,FMD和GNT均逐渐降低。结论内皮舒张功能改变与CHD患者冠状动脉病变程度、中医证型之间具有一定的相关性。

Objective To investigate the correlation between the endothelial diastolic function and the degree of coronary artery disease changes and TCM syndrome types in patients with coronary atherosclerotic heart disease（ CHD）. Methods Collecting qualified 328 cases of CHD,with cardiovascular imaging system,using digital subtraction angiography with Judkins method to observe the degree of coronary artery lesions; Using color ultrasonic diagnostic instrument detection brachial artery endothelial diastolic function,then analysis the correlation between the endothelial diastolic function and the degree of coronary artery lesions,TCM syndrome type. Results Correlation between endothelial function and TCM syndrome types： flow mediated dilation（ FMD） and nitroglycerin（ GNT） were the most severe damage in the patients with phlegm and blood stasis syndrome in CHD,secondly,the phlegm turbidity syndrome,blood stasis syndrome; non phlegm non blood stasis syndrome was more light. The comparison of non phlegm non blood stasis syndrome,blood stasis syndrome,phlegm turbidity syndrome and phlegm and blood stasis syndrome had statistical significance（ P〈0. 01,P〈0. 05）. Correlation between endothelial function and coronary artery disease： GNT and FMD were decreased gradually with the severity of coronary stenosis; FMD and GNT were gradually decreased with the increase of the number of coronary artery lesions. Results The changes of endothelial function,the degree of coronary artery lesions in patients with CHD and the TCM syndrome types have a certain correlation.