王永,杨慧敏,陈燕,王永槐,于航,张维新,孟平平,马春燕,贾大林

• 1:中国医科大学人民医院辽宁省人民医院心血管病中心
• 2:中国医科大学附属第一医院心内科
• 3:中国医科大学附属第一医院心脏超声科

摘要(Abstract)：

目的探讨冠状动脉慢血流现象(coronary slow flow phenomenon,CSFP)的危险因素,同时测定肱动脉血流介导性舒张功能(flowmedi-ateddilation,FMD),并探究其与CSFP的关系,FMD与平均冠状动脉TIMI血流帧数计数(mean TIMI f rame count,m TFC)、出现CSFP冠状动脉血管支数的关系。方法选择2014年1月至2015年12月因心绞痛就诊于中国医科大学附属第一医院,并行择期冠状动脉造影术疑诊为冠心病的患者,其中冠状动脉造影显示冠状动脉狭窄<40%且m TFC>27帧患者52例为CSFP组。选择同期冠状动脉造影显示冠状动脉狭窄<40%并且血流正常者44例为对照组。比较两组患者的临床基础资料、血生化指标、FMD水平。结果 CSFP组胱抑素C(Cys-C)明显高于对照组[(0.9±0.1)mg/L比(0.8±0.1)mg/L,P=0.012],差异有统计学意义,其余血生化指标比较,差异均无统计学意义(均P>0.05)。CSFP组FMD显著低于对照组[(4.7±2.3)%比(5.9±2.2)%,P=0.007],差异有统计学意义。CSFP组校正的TIMI帧数计数在前降支[(45.6±14.3)帧/s比(23.5±5.9)帧/s,P<0.001],TIMI帧数计数在回旋支[(32.0±10.4)帧/s比(18.0±3.9)帧/s,P<0.001]、右冠状动脉[(36.7±15.0)帧/s比(18.2±4.3)帧/s,P<0.001],及m TFC[(38.1±11.1)帧/s比(19.9±3.7)帧/s,P<0.001]均显著高于对照组,差异均有统计学意义。CSFP组患者FMD与m TFC负相关(r=0.330,P=0.001)。CSFP组患者3支慢血流现象FMD[(4.17±2.01)%比(6.34±2.69)%,P=0.037]明显低于对照组。结论 CSFP可能反映早期冠状动脉粥样硬化性改变。

关键词(KeyWords)： 冠状动脉慢血流现象;危险因素;TIMI血流帧数计数;血流介导性舒张功能;内皮功能紊乱

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王永,杨慧敏,陈燕,王永槐,于航,张维新,孟平平,马春燕,贾大林

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