冠状动脉慢血流现象临床相关危险因素分析

doi:10.3969/j.issn.1003-9198.2021.10.006

摘要/Abstract

摘要： 目的探讨临床常见炎性指标与冠状动脉慢血流(coronary slow flow,CSF)之间的潜在联系,探究CSF现象的相关危险因素。方法回顾性分析2018年7月至2020年6月在南京医科大学第二附属医院行冠脉造影术(coronary angiography,CAG)的120例老年病人的临床资料,将其中58例CSF病人设为观察组,另外62例经CAG诊断为冠状动脉狭窄＜40%且无CSF的病人设为对照组。比较2组病人的一般资料、CAG检查结果、颈部超声检查结果,血清炎性因子hs-CRP、IL-6及中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平。采用多因素Logistic回归分析影响CSF发生的相关因素。结果 2组一般社会学资料差异均无统计学意义(P>0.05)。观察组病人的校正TIMI帧数(CTFC)、校正左前降支(cLAD)TIMI帧数、左回旋支(LCX)TIMI帧数、右冠脉(RCA)TIMI帧数、平均颈动脉内-中膜厚度(Mean-IMT)均大于对照组,血清hs-CRP、IL-6、NGAL水平均高于对照组,差异具有统计学意义(P<0.05或P<0.01)。多因素Logistic回归分析表明,血清hs-CRP、IL-6、NGAL,Mean-IMT及CTFC均是CSF发生的影响因素。结论 CSF病人具有更高的颈动脉内-中膜厚度,血清炎性因子hs-CRP、IL-6、NGAL,Mean-IMT及CTFC均是影响CSF发生的独立危险因素。

关键词: 冠状动脉慢血流, 超敏C反应蛋白, 白介素6, 中性粒细胞明胶酶相关脂质运载蛋白, 危险因素

Abstract: Objective To explore the potential relationship between common clinical inflammatory indicators and coronary slow flow (CSF), and to explore the risk factors for CSF. Methods The clinical data of 120 elderly patients who underwent coronary angiography (CAG) in the Second Affiliated Hospital of Nanjing Medical University from July 2018 to June 2020 were retrospectively analyzed. Among them, 58 patients with CSF were enrolled as the observation group, and 62 patients with coronary stenosis <40% and not diagnosed as CSF by CAG were enrolled as the control group. The general information, results of CAG and neck ultrasound, the levels of serum high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and neutrophil gelatinase-associated lipocalin (NGAL) were compared between the two groups. The risk factors for CSF were analyzed by multivariate Logistic regression analysis. Results There were no significant differences in general sociological data between the two groups (P>0.05). The corrected TIMI frame count (CTFC), corrected left anterior descending (cLAD) TIMI frame count, left circumflex artery (LCX) TIMI frame count, right coronary artery (RCA) TIMI frame count and Mean carotid intima-media thickness (Mean-IMT) in the observation group were higher than those in the control group; The levels of serum hs-CRP, IL-6 and NGAL in the observation group were higher than those in the control group, with statistically significant differences (P<0.05 or P<0.01). Multivariate Logistic regression analysis showed that hs-CRP, IL-6, NGAL, Mean-IMT and CTFC were risk factors affecting CSF. Conclusions The patients with CSF have higher level of intima-media thickness. Serum inflammatory factors such as hs-CRP, IL-6 and NGAL, Mean-IMT and CTFC are risk factors affecting CSF.

Key words: coronary slow flow, high sensitivity C-reactive protein, interleukin-6, neutrophil gelatinase-associated lipocalin, risk factor

中图分类号:

R 543.3

张玥, 谭晓. 冠状动脉慢血流现象临床相关危险因素分析[J]. 实用老年医学, 2021, 35(10): 1019-1022.

ZHANG Yue, TAN Xiao. Analysis of clinical risk factors for slow coronary artery flow[J]. Practical Geriatrics, 2021, 35(10): 1019-1022.

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