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目的:观察冠心病(CHS)患者肱动脉血流介导的舒张功能与冠状动脉(冠脉)病变之间的关系。方法:选择冠脉造影(CAG)患者107例,根据cAG结果分为冠脉正常组28例、冠脉早期病变组31例、CHD组48 例,CHD组采用Gensini评分进一步分为轻度病变(1-20分)26例,重度病变(≥20分)22例。在CAG前24 h 内应用高分辨率超声检测肱动脉血流介导的舒张功能,与CAG结果作对照分析。结果:CHD组中轻度病变与重度病变者较冠脉早期病变组及冠脉正常组的肱动脉内皮依赖的舒张功能(EDD)明显降低[(4．75±0．94)％、 (3．67±1．01)％:(5．98±0．89)％、(6．15±0．97)％,P<0．05或0．01];重度冠脉病变者EDD较轻度冠脉病变者明显下降[(3．67±1．01)％:(4．75±0．94)％,P<0．05]。而硝酸甘油介导的血管扩张功能(非EDD)在各组间差异无统计学意义(P>0．05)。肱动脉EDD与冠脉病变积分呈负相关(r=0．72,P<0．01)。结论: CHD患者常存在肱动脉EDD受损,肱动脉EDD可间接反映冠脉病变程度。
Objective: To observe the relationship between brachial artery-mediated diastolic function and coronary artery (coronary artery) in patients with coronary heart disease (CHS). Methods: A total of 107 patients underwent coronary angiography (CAG) were divided into normal coronary artery group (n = 28), early coronary artery group (n = 31) and CHD group (n = 48). The Gensini score was further divided into mild lesions 1-20 points) in 26 cases, severe lesions (≥ 20 points) in 22 cases. The brachial artery-mediated diastolic function was measured by high-resolution ultrasound within 24 h before CAG, and compared with CAG results. Results: The EDD of brachial artery in patients with mild and severe lesions in CHD group was significantly lower than that in early coronary artery disease group and normal coronary artery group [(4.75 ± 0.94)%, (3) .67 ± 1.01)% (5.98 ± 0.89)%, (6.15 ± 0.97)% respectively, P <0.05 or 0.01). Patients with severe coronary artery disease had a lower EDD Degree of coronary lesions were significantly decreased [(3.67 ± 1.01)% :( 4.75 ± 0.94)%, P <0.05]. However, no significant difference was found in nitroglycerin-mediated vasodilation (non-EDD) among the groups (P> 0.05). Brachial artery EDD was negatively correlated with coronary artery disease score (r = 0.72, P <0.01). CONCLUSION: EDD of brachial artery is often impaired in patients with CHD. EDD of brachial artery may indirectly reflect the degree of coronary lesion.