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目的:通过常规冠脉造影,运用数字跟踪技术软件测定冠脉造影正常患者冠脉血流储备(Coronary Flow Reserve,CFR),冠脉内注射乙酰胆碱(Acetylcholine,Ach)并检测高敏C反应蛋白(high Sensitivity,hs CRP)含量评价内皮功能,观察不同危险因素组别间CFR与内皮功能的变化,探讨其变化意义。方法:118拟诊冠心病患者,平均年龄61±11(岁),按不同危险因素分成高血压、高胆固醇血症、肥胖、吸烟、2型糖尿病及≥2危险因素组,另设对照组24例,平均年龄56±12.9(岁)。常规冠脉造影正常,运用数字跟踪技术软件测定患者CFR,冠脉内注射Ach,抽血检测hs CRP含量,根据Ach阳性率、hs CRP含量评价内皮功能,观察不同组别间CFR、Ach阳性率、hs CRP的变化。结果:高血压、吸烟组及≥2危险因素组CFR低于对照组,Ach阳性率及hs CRP水平高于对照组;肥胖组、糖尿病组及高胆固醇血症组CFR低于对照组,Ach阳性率及hs CRP水平高于对照组,但无显著差异;糖尿病组hs CRP水平高于对照组。结论:数字跟踪技术软件可方便测定CFR;具有不同危险因素人群存在冠脉血流储备降低且伴有内皮功能异常。
OBJECTIVE: To determine coronary flow reserve (CFR), coronary artery injections of acetylcholine (Ach) and high-sensitivity C-reactive protein Sensitivity, hs CRP) levels were evaluated endothelial function, CFR and endothelial function between different risk groups were observed to explore the significance of changes. Methods: 118 patients with CHD were enrolled in this study. Their mean age was 61 ± 11 (years). Hypertension, hypercholesterolemia, obesity, smoking, type 2 diabetes mellitus and ≥2 risk factors were divided according to different risk factors. For example, the average age of 56 ± 12.9 (years). The routine coronary angiography was normal. The CFR, the intracoronary injection of Ach and the hsCRP in the blood were measured by digital tracking software. The endothelial function was evaluated according to the Ach positive rate and the hs CRP level. The positive rates of CFR and Ach in different groups were observed , Hs CRP changes. Results: The CFR of hypertension group, smoking group and ≥2 risk factor group were lower than that of control group, the positive rate of Ach and the level of hs CRP were higher than those of control group. The CFR of obesity group, diabetes group and hypercholesterolemia group were lower than that of control group Rate and hs CRP levels higher than the control group, but no significant difference; diabetic hs CRP levels higher than the control group. CONCLUSIONS: Digital tracking software is convenient for the determination of CFR; coronary flow reserve is associated with endothelial dysfunction in populations with different risk factors.