反应性充血指数对冠状动脉粥样硬化预测价值

Predictive Value of Reactive Congestive Index in Coronary Atherosclerosis

目的应用内皮功能-外周动脉张力测定技术(Endothelial function-peripheral arterial tonometry technique,Endo-PAT)检测反应性充血指数(RHI)和冠状动脉造影术对冠状动脉进行Gensini积分,了解年龄、高血压、糖尿病等危险因素RHI和冠状动脉Gensini积分的变化情况和相关性,RHI对冠状动脉粥样硬化性和冠状动脉粥样硬化性心脏病的预测价值。方法收集1015年1月至2016年6月需要行冠状动脉造影的志愿纳入研究的志愿者680例,在冠状动脉造影前进行RHI检查,后进行冠状动脉造影检查和Gensini积分。比较不同年龄和高血压、糖尿病、冠状动脉粥样硬化性心脏病等不同亚组RHI、Gensini积分的变化,了解RHI与冠状动脉粥样硬化性心脏病、高血压、糖尿病、年龄等因素的相关性。结果在各个亚组组中,与无危险因素组比较,单纯高血压组和高血压合并其他危险因素组RHI均降低,差异有统计学意义(P<0. 05);高血压合并糖尿病组RHI与单纯高血压组相比较更低,差异有统计学意义(P<0. 05)。在进行冠状动脉造影Gensini积分研究中发现,与无危险因素组比较,高血压和并糖尿病和高血压合并非糖尿病危险因素组Gensini积分更高,代表冠状动脉狭窄程度更加明显。RHI与冠状动脉造影确诊是否有冠状动脉粥样硬化性心脏病负相关(r=-0. 6762),与高血压、年龄、糖尿病、Gensini积分均负相关。结论 RHI与冠状动脉粥样硬化和冠心病均具有较好的相关性,RHI降低可以作为对冠状动脉粥样硬化的预测因子,特别可以作为冠状动脉粥样硬化性心脏病的预测因子。

Objective To detect the reactive hyperemia index(RHI)by Endothelial function-peripheral arterial tonometry technique(Endo-PAT)and to make Gensini score by coronary angiography,so as to investigate the changes and correlation of RHI and coronary Gensini score in age,hypertension,diabetes mellitus and other risk factors,and the predictive value of RHI in coronary atherosclerosis and coronary atherosclerotic heart disease. Methods A total of 680 volunteers who needed coronary angiography from January 2015 to June 2016 were enrolled in the study.RHI was performed before coronary angiography,then coronary angiography and Gensini scores were performed.The changes of RHI,Gensini scores in different subgroups such as hypertension,diabetes,coronary atherosclerotic heart disease were compared,and the correlation between RHI and coronary atherosclerotic heart disease,hypertension,diabetes mellitus and age was investigated. Results In each subgroup group,compared with the non-risk factors group,the RHI of the hypertension group and the hypertension combined with other risk factors group were lower than that of the non-risk factor group( P <0.05);The RHI of hypertension with diabetes mellitus group was lower than that of simple hypertension group( P <0.05).In the study of coronary angiography Gensini score,compared with non-risk factors group,the Gensini score of hypertension and diabetes mellitus and hypertension with non-diabetic risk factors group was higher than that of non-diabetic risk factor group,indicating the degree of coronary artery stenosis was more obvious.RHI was negatively correlated with coronary atherosclerotic heart disease( r =0.6762),hypertension,age,diabetes,and Gensini score. Conclusion There is a good correlation between RHI and coronary atherosclerosis and coronary heart disease.The decrease of RHI can be used as a predictor of coronary atherosclerosis,especially as a predictor of coronary atherosclerotic heart disease.