冠状动脉不同病变程度与外周微循环的相关性研究
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摘要
目的:探讨冠状动脉(冠脉)病变患者不同病变程度与外周微循环的关系,并进一步探讨与外周微循环相关的因素。方法:随机选择可疑冠心病患者134例,行手指复温试验评估外周微循环功能,而后根据冠脉造影结果和Gensini评分分为正常组22例、低分组38例、中间分值组37例和高分组37例。比较各组的临床特征,应用单因素方差分析探讨冠脉不同病变程度与外周微循环之间的关系,并进一步应用Spearman相关分析和多元线性回归分析探讨临床生化指标与外周微循环的相关性。结果:单因素方差分析发现,与正常组相比,中间分值组和高分组手指复温时间延长,且有统计学差异(均P<0.05)。Spearman分析发现,手指复温时间与年龄、BMI、三酰甘油(TG)、尿素(UREA)、肌酐(CRE)、肾小球滤过率(GFR)、左室射血分数(LVEF)和Gensini评分具有相关性。多元线性回归分析发现手指复温时间与年龄呈正相关(r=0.20,P=0.038),与BMI、LVEF呈负相关(r=-0.19,P=0.022,r=-0.21,P=0.014)。结论:冠脉病变与外周微循环功能密切相关,两者可能互为因果。外周微循环与年龄、BMI和LVEF具有相关性,三者对微循环功能可能具有一定预测价值。
Objective:To explore the relationship between different degrees of coronary lesions and peripheral microcirculation in patients with coronary disease,and to further explore the factors related to peripheral microcirculation.Method:The 134 patients with suspected coronary heart disease were randomly selected,and the peripheral microcirculation function was evaluated using finger cooling test.Then according to the results of coronary angiography and Gensini scores,22 patients were assigned into normal group,38 patients into low score group,37 patients into middle score group and 37 patients into high score group respectively.The baseline characteristics of each group were compared,and One-way ANOVA was used to investigate the relationship between different degrees of coronary disease and peripheral microcirculation.Further,Spearman correlation analysis and multiple linear regression analysis were used to explore the correlation between clinical biochemical indicators and peripheral microcirculation.Result:One-way ANOVA found that,compared with the normal group,rewarming times of the finger of the middle score group and the high score group were prolonged,and the differences were statistically significant(both P<0.05).Spearman analysis found that rewarming time of the finger was associated with age,BMI,TG,UREA,CRE,GFR,LVEF,and Gensini scores.Multiple linear regression analysis found that RT was positively correlated with age(r=0.20,P=0.038)and negatively correlated with BMI and LVEF(r=-0.19,P=0.022,r=-0.21,P=0.014,respectively).Conclusion:Coronary lesions are closely related to peripheral microcirculation,and maybe they are in cause-effect relationship.Peripheral microcirculation has a correlation with age,BMI and LVEF,and the three may have certain predictive value for microcirculation function.
Objective:To explore the relationship between different degrees of coronary lesions and peripheral microcirculation in patients with coronary disease,and to further explore the factors related to peripheral microcirculation.Method:The 134 patients with suspected coronary heart disease were randomly selected,and the peripheral microcirculation function was evaluated using finger cooling test.Then according to the results of coronary angiography and Gensini scores,22 patients were assigned into normal group,38 patients into low score group,37 patients into middle score group and 37 patients into high score group respectively.The baseline characteristics of each group were compared,and One-way ANOVA was used to investigate the relationship between different degrees of coronary disease and peripheral microcirculation.Further,Spearman correlation analysis and multiple linear regression analysis were used to explore the correlation between clinical biochemical indicators and peripheral microcirculation.Result:One-way ANOVA found that,compared with the normal group,rewarming times of the finger of the middle score group and the high score group were prolonged,and the differences were statistically significant(both P<0.05).Spearman analysis found that rewarming time of the finger was associated with age,BMI,TG,UREA,CRE,GFR,LVEF,and Gensini scores.Multiple linear regression analysis found that RT was positively correlated with age(r=0.20,P=0.038)and negatively correlated with BMI and LVEF(r=-0.19,P=0.022,r=-0.21,P=0.014,respectively).Conclusion:Coronary lesions are closely related to peripheral microcirculation,and maybe they are in cause-effect relationship.Peripheral microcirculation has a correlation with age,BMI and LVEF,and the three may have certain predictive value for microcirculation function.
引文
[1]张叔伦.冠心病与外周微循环[J].医学研究通讯,1983,9(1):13-16.
[2]曾秋棠,彭昱东.急性心肌梗死与冠状动脉微循环障碍[J].临床心血管病杂志,2017,33(5):404-406.
[3] Bonetti PO,Pumper GM,Higano ST,et al.Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia[J].J Am Coll Cardiol,2004,44(11):2137-2141.
[4] Rubinshtein R,Kuvin JT,Soffler M,et al.Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events[J].Eur Heart J,2010,31(9):1142-1148.
[5] Abularrage CJ,Sidawy AN,Aidinian G,et al.Evaluation of the microcirculation in vascular disease[J].J Vasc Surg,2005,42(3):574-581.
[6] Van den Brande P,von Kemp K,De Coninck A,et al.Laser Doppler flux characteristics at the skin of the dorsum of the foot in young and in elderly healthy human subjects[J].Microvasc Res,1997,53(2):156-162.
[2]曾秋棠,彭昱东.急性心肌梗死与冠状动脉微循环障碍[J].临床心血管病杂志,2017,33(5):404-406.
[3] Bonetti PO,Pumper GM,Higano ST,et al.Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia[J].J Am Coll Cardiol,2004,44(11):2137-2141.
[4] Rubinshtein R,Kuvin JT,Soffler M,et al.Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events[J].Eur Heart J,2010,31(9):1142-1148.
[5] Abularrage CJ,Sidawy AN,Aidinian G,et al.Evaluation of the microcirculation in vascular disease[J].J Vasc Surg,2005,42(3):574-581.
[6] Van den Brande P,von Kemp K,De Coninck A,et al.Laser Doppler flux characteristics at the skin of the dorsum of the foot in young and in elderly healthy human subjects[J].Microvasc Res,1997,53(2):156-162.