冠状动脉慢血流心肌灌注异常与冠脉局部内皮素-1和一氧化氮浓度临床相关性分析

The Clinical Correlation Analysis between Endothelin-1 /Nitric Oxide Oncentrations and Coronary Slow Flow with Myocardial Perfusion Defect

目的探讨冠状动脉慢血流99m Tc MIBI心肌血流灌注断层显像异常与冠脉内局部内皮素-1（ET-1）和一氧化氮（NO）浓度相关性分析。方法将2013年8月~2015年2月在某医院心内科冠状动脉慢血流98例患者,同期行SPECT检查。42例慢血流合并心肌灌注分布异常者作为慢血流核素分布异常组,其余56例为对照组。描述两组临床特征、冠心病危险因素及实验室检查指标。结果与对照组比较,慢血流合并核素分布异常组ET-1水平显著增高（P〈0.05）,而血清NO水平显著降低（P〈0.05）。Logistic回归分析显示慢血流核素分布异常吸烟者高于非吸烟者（β=1.212,OR=4.564,P〈0.05）。结论冠脉局部ET-1升高,NO降低可能诱发慢血流心肌血流灌注断层显像异常,吸烟可能加重这种现象。

Objective To investigate the relation between Tc-99m-Methoxy-isobutyl-isonitrile myocardial perfusion defect and intracoronary plasma endothelin-1（ET-1）/ nitric oxide（NO） concentrations in patients with coronary slow-flow. Methods During the period from 2013 to2015, 98 consecutive patients with coronary slow flow during angiography, 99m-Tc-Methoxy-isobutyl-isonitrile（MIBI） was injected in all patients and SPECT imaging performed. The 42 coronary slow-flow patients with MIBI myocardial hypoperfusion served as myocardial perfusion defect group（MPDG）. The other patients served as control group（CG）.Baseline characteristics labparameters and coronary risk factors were described consequently. Results The 42 patients with significant perfusion defect groups that intracoronary plasma ET-1 concentrations were significantly higher than control group and NO concentrations were significantly lower than control group（P〈0.05）.Logistic regression analysis suggested that coronary slow flow patients with myocardial perfusion defect were significantly higher in smokers than coronary slow-flow normal myocardial perfusion patients,（β=1.212,OR=4.564,P〈0.05）. Conclusions There is a significant relation between ET-1 and NO concentrations and cronary flow with myocardial perfusion defect.Increased ET-1 and discreased NO concentration are probably induced it. Smoking is strongly associated with myocardial perfusion defect.