气流受限与无症状冠状动脉粥样硬化的相关性研究

Correlation between Airflow Obstruction and Asymptomatic Coronary Atherosclerosis

目的探讨气流受限与无症状冠状动脉粥样硬化的相关性。方法选取2013—2015年宝鸡市中医医院心内科收治的无症状冠状动脉粥样硬化患者120例,根据肺功能检查结果分为气流正常组102例和气流受限组18例。比较两组患者一般资料、肺功能指标、实验室检查指标、冠状动脉狭窄情况及CT冠状动脉成像(CCTA)评分,气流受限与无症状冠状动脉粥样硬化患者CCTA评分的相关性分析采用Spearman秩相关分析。结果两组患者性别、体质指数(BMI)、收缩压、舒张压及高血压、糖尿病、脂代谢异常发生率比较,差异无统计学意义(P>0.05);气流受限组患者年龄大于气流正常组,吸烟率高于气流正常组(P<0.05)。两组患者用力肺活量(FVC)比较,差异无统计学意义(P>0.05);气流受限组患者用力肺活量占预计值的百分比(FVC%pred)、第1秒用力呼气容积占预计值的百分比(FEV_1%pred)、FEV_1/FVC比值低于气流正常组,第1秒用力呼气容积(FEV_1)小于气流正常组(P<0.05)。两组患者血红蛋白、空腹血糖、糖化血红蛋白(HbA_(1c))、血肌酐、内生肌酐清除率、总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)比较,差异无统计学意义(P>0.05);气流受限组患者超敏C反应蛋白(hs-CRP)高于气流正常组(P<0.05)。气流受限组患者冠状动脉梗阻性狭窄发生率及冠状动脉钙化积分(CACS)、冠状动脉粥样硬化负荷评分(ABS)、冠状动脉粥样硬化阻塞评分(ABOS)、节段累及评分(SIS)、节段狭窄评分(SSS)高于气流正常组(P<0.05);Spearman秩相关分析结果显示,气流受限与无症状冠状动脉粥样硬化患者CACS(r_s=0.634)、ABS(r_s=0.782)、ABOS(r_s=0.431)、SIS(r_s=0.523)、SSS(r_s=0.803)呈正相关(P<0.05)。结论存在气流受限的无症状冠状动脉粥样硬化患者冠状动脉狭窄程度和病变严重程度较重,且气流受限与无症状冠状动脉粥样硬化患者冠状动脉狭窄程度和病变严重程度呈正相关。

Objective To investigate the correlation between airflow obstruction and asymptomatic coronary atherosclerosis. Methods From 2013 to 2015,a total of 120 patients with asymptomatic coronary atherosclerosis were selected in the Department of Cardiology,Traditional Chinese Medicine Hospital of Baoji,and they were divided into A group（with normal airflow,n=102）and B group（with airflow obstruction,n=18）according to pulmonary function examination results. General information,index of pulmonary function,laboratory examination results,incidence of coronary artery stenosis and CCTA score were compared between the two groups,and Spearman rank correlation analysis was used to analyze the correlation between airflow obstruction and asymptomatic coronary atherosclerosis. Results No statistically significant differences of gender,BMI,SBP,DBP,incidence of hypertension,diabetes or dyslipidemia was found between the two groups（P〈0.05）;age in B group was statistically significantly older than that in A group,and smoking rate in B group was statistically significantly higher than that in A group（ P〈0.05）. No statistically significant differences of FVC was found between the two group（sP〈0.05）,while FVC%pred,FEV1%pred and FEV1/FVC ratio in B group were statistically significantly lower than those in A group,FEV1 in B group were statistically significantly less than those in A group（P〈0.05）. No statistically significant differences of Hb,FPG,HbA（1c）,Scr,Ccr,TC,TG,HLD-C or LDL-C was found between the two groups（P〈0.05）,while hs-CRP in B group was statistically significantly higher than that in A group（P〈0.05）. Incidence of obstructive stenosis,CACS,ABS,ABOS,SIS and SSS in B group were statistically significantly higher than those in A group（P〈0.05）;Spearman rank correlation analysis results showed that,airflow obstruction was positively correlated with CACS（rs=0.634）,ABS（rs=0.782）,ABOS（rs=0.431）,SIS（rs=0.523） and SSS（rs=0.803）in patients with asymptomatic coronary atherosclerosis,respectively（P〈0.05）. Conclusion Severity of coronary artery stenosis and lesions is relatively bad in asymptomatic coronary atherosclerosis patients with airflow obstruction,meanwhile airflow obstruction is positively correlated with the severity of coronary artery stenosis and lesions.