非阻塞性冠状动脉粥样硬化患者内皮功能不全的影响因素

Influencing factors of endothelial dysfunction in patients with non-obstructive coronary atherosclerosis

摘要:

目的 探讨非阻塞性冠状动脉粥样硬化患者内皮功能不全的影响因素。方法 选取2013年6月至2015年6月首都医科大学宣武医院心脏内科收治的因胸痛疑诊冠心病、经冠状动脉造影检查证实为非阻塞性冠状动脉粥样硬化症(冠状动脉狭窄＜50%)的患者110例。行肱动脉血流介导内皮依赖性血管舒张功能(FMD)检测,用流式细胞仪检测外周血CD133⁺/KDR⁺、CD34⁺/KDR⁺以及CD34⁺/CD133⁺/KDR⁺内皮祖细胞(EPCs)。根据FMD分为对照组(FMD＞10%)和内皮功能不全组(FMD≤10%)。采用SPSS 19.0软件进行统计分析。应用logistic回归模型分析影响内皮功能不全的因素。结果 2组患者CD133⁺/CDR⁺、CD34⁺/KDR⁺或CD34⁺/CD133⁺/KDR⁺循环EPCs数量比较,差异无统计学意义(P＞0.05)。多因素logistic回归分析显示,年龄是影响内皮功能不全的独立危险因素(95%CI 1.004~1.104,P=0.033)。结论 非阻塞性冠状动脉粥样硬化患者内皮功能不全的独立影响因素是年龄,而非循环EPCs数量。

Abstract:

Objective To investigate the influencing factors of endothelial dysfunction in patients with non-obstructive coronary atherosclerosis. Methods A total of 110 consecutive patients with suspected coronary artery diseases and then diagnosed with non-obstructive coronary atherosclerosis (coronary stenosis <50%) by coronary angiography in Xuanwu Hospital, Capital Medical University from June 2013 to June 2015 were recruited in this study. Flow mediated dilatation (FMD) was measured by echocardiography, and circulating endothelial progenitor cells (EPCs) were enumerated by flow cytometry as mononuclear cells expressing a combination of KDR⁺, CD34⁺ and/or CD133⁺. The patients were divided into control (FMD >10%) and endothelial dysfunction group (FMD ≤10%). SPSS statistics 19.0 was used to perform the statistical analysis. Logistic regression analysis was employed to analyze the influencing factors for endothelial dysfunction. Results There were no significant differences in the cell counts of circulating EPCs, defined as CD34⁺/KDR⁺,CD133⁺/KDR⁺ or CD34⁺/CD133⁺/KDR⁺ cells between the 2 groups (P>0.05). Logistic regression analysis revealed that age was an independent risk factor for endothelial dysfunction (95%CI 1.004-1.104, P=0.033). Conclusion Age, not the count of circulating EPCs, is an independent influencing factor of endothelial dysfunction in patients with non-obstructive cornary atherosclerosis.