用超声回声跟踪技术评估冠状动脉慢血流患者颈动脉硬化的研究

Research on the Correlation between Carotid Arteriosclerosis and Coronary Slow Flow Phenomenon

目的研究冠状动脉慢血流(coronary slow flow,CSF)患者的颈动脉硬化情况。方法选取具有相似危险因素分层的CSF患者和冠状动脉血流正常(normal coronary arteries,NCA)的人群各45名。通过实时血管回声跟踪(echo-tracking,ET)系统,获得双侧颈动脉的硬化指数(stiffness parameter,β)、压力-应变弹性指数(pressure-strain elastic modulus,Ep)、顺应性(arterial compliance,AC)和脉搏波传递速度(pulse-wave velocity,PWV)。对两组患者进行血清超敏C反应蛋白(high sensitivity c-reactive protein,Hs-CRP)水平测定,通过线性回归分析评价Hs-CRP和颈动脉硬化各项参数的相关性。结果 CSF组β、Ep和PWV显著高于NCA组(β:11.80±3.19 vs 9.70±3.76,P<0.01;Ep:149.90±44.47 vs 130.10±41.56,P<0.05;PWV:7.40±0.84 vs 7.00±1.08,P<0.05),AC低于NCA组(0.640±0.180 vs 0.760±0.192,P<0.01)。CSF组Hs-CRP水平显著的高于NCA组(13.90±10.66 vs 9.30±6.33,P<0.05)。Hs-CRP水平可能与β(r=0.272,P=0.005)、Ep(r=0.411,P=0.003)和PWV(r=0.452,P=0.001)具有一定的正相关性,但是和AC(r=-0.293,P=0.025)呈负相关。结论在CSF患者,ET技术是一种简单、实用的评估颈动脉硬化的方法;CSF和颈动脉动脉硬化具有很好的相关性。

Objective To investigate the carotid arterial stiffness in patients with coronary slow flow （ CSF） .Methods forty-five patients with CSF and Forty -five persons having normal coronary arteries （ NCA） detected by coronary angiography with a similar distri-bution of risk factors were recruited .Stiffness parameter （β）, pressure-strain elastic modulus （Ep）, arterial compliance （AC） and lo-cal pulse-wave velocity （PWV） were obtained at the level of bilateral carotid artery by a real time echo -tracking system.Serum levels of high-sensitivity C-reactive protein （ hs-CRP） were measured in two groups of subjects .Linear regression analysis were performed to evaluate the correlation between hs -CRP and the parameters of the carotid artery stiffness .Results We found that stiffness parameter （β）, Ep and PWV were significantly higher in CSF group those that of control group （β：11.80 ±3.19 vs 9.70 ±3.76,P〈0.01;Ep：149.90 ±44.47 vs 130.10 ±41.56,P〈0.05;PWV：7.40 ±0.84 vs 7.00 ±1.08,P〈0.05）, AC was lower than that of control group （0.640 ±0.180 vs 0.760 ±0.192 ,P〈0.01）.The levels of high-sensitivity C-reactive protein （hs-CRP） was significantly higher in CSF group than that of control group （13.90 ±10.66 vs 9.30 ±6.33,P〈0.05）.The levels of hs-CRP was positively correlated with theβ（r=0.272,P=0.005）, Ep（r=0.411,P=0.003）, and PWV（r=0.452,P=0.001）, but negatively correlated with AC （r=-0.293,P=0.025）.Conclusion Echo-tracking technology is a simple practical method to evaluate carotid artery stiffness in patients with CSF and correlation well with coronary slow flow and artery stiffness .