急性冠脉综合征男性患者舌下络脉与Gensini积分的相关性

The Correlation between Sublingual Collaterals and Gensini Scores in Male Patients with Acute Coronary Syndrome

目的:观察急性冠脉综合征(acute coronary syndromes,ACS)男性患者舌下络脉与冠脉病变的关系,探讨舌下络脉与冠脉狭窄程度积分(Gensini积分)的相关性。方法:分析104例急性冠脉综合征男性患者舌下络脉征象,以Gensini冠脉评分评价冠脉病变程度,将患者根据Gensini冠脉病变评分的四分位数分为四个等级,Q1组28例(0~22分)、Q2组25例(23~38分)、Q3组28例(39~72分)、Q4组23例(73~160分),并将其与可疑冠心病男性患者经造影结果为阴性对照组30例进行比较。结果:各组年龄、吸烟史、糖尿病史、体质指数(body mass index,BMI)、血糖(blood glucose,GLU)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、不稳定性心绞痛(unstable angina,UA)水平比较差异均无统计学意义(P>0.05);各组高血压病史、LDL-C、HCY水平比较差异有统计学意义(P<0.05)。ACS舌下络脉0~Ⅲ度患者所占比例分别为3.85%、24.04%、51.92%、20.19%,以Ⅰ度、Ⅱ度及Ⅲ度为主,异常变化率为72.12%;对照组舌下络脉0~Ⅲ度患者所占比例分别为53.33%、33.33%、13.33%、0.00%,以0度及Ⅰ度为主,异常变化率为13.33%;经Spearman相关检验,ACS患者Gensini积分与舌下脉络变化有关(r=0.524,P<0.01),舌下脉络分级越高,Gensini积分越高。青、中、老年组舌下络脉异常变化率分别为31.25%、78.05%、78.72%,舌下脉络变化与年龄有关(r=0.249,P<0.05),随年龄增长舌下脉络分级加重。结论:ACS患者舌下脉络与冠脉病变有一定相关性,舌下络脉分级越高,Gensini积分越高。

Objective: To observe the correlation between sublingual collaterals and coronary artery disease in male patients with ACS, and explore the connections between sublingual collaterals and Gensini scores.Methods: The signs of sublingual collaterals in 104 male patients with ACS were analyzed, the degree of coronary artery disease was evaluated by Gensini artery score, the patients were classified into four grades according to the quartile of Gensini coronary lesion score, 28 cases in Q1 group(0 to 22 points), 25 cases in Q2 group(23 to 38 points), 28 cases in Q3 group(39 to 72 points), 23 cases in Q4 group(73 to 160 points), and these patients were compared with 30 cases in negative control group who were suspected coronary heart disease and negative by angiography. Results: The difference had no statistical meaning in age, history of smoking, diabetes mellitus history, the levels of BMI, GLU, TG, TC, HDL-C and UA in different groups(P>0.05);the difference had statistical meaning in history of hypertension, the levels of LDL-C and HCY in different groups(P<0.05). The proportions of ACS patients with sublingual collaterals of 0 to Ⅲ degree were 3.85%, 24.04%, 51.92% and20.19%, mainly of the degree Ⅰ, Ⅱ and Ⅲ, abnormal change rate was 72.12%;the proportions of ACS patients with sublingual collaterals of 0 to Ⅲ degree were 53.33%, 33.33%, 13.33% and 0.00% respectively, mainly of the degree 0 and Ⅰ, abnormal change rate was 13.33%;Gensini scores of ACS patients were related to the changes of sublingual collaterals by Spearman correlation test(r=0.524, P<0.01), the higher the classifications of sublingual collaterals were, the higher Gensini scores were. Abnormal change rates of sublingual collaterals in young, middleaged and elderly groups were 31.25%, 78.05% and 78.72% respectively, the changes of sublingual collaterals were related to age(r=0.249, P<0.05), the sublingual collaterals grading increased with age. Conclusion: There is a certain correlation between sublingual collaterals of ACS patients and coronary artery disease, the higher sublingual collaterals grading is, the higher Gensini scores are.