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目的探讨影响冠状动脉慢血流现象的临床因素和冠状动脉解剖因素。方法入选2008年3月—2009年9月因怀疑冠心病于我科行冠状动脉造影检查,结果示冠状动脉无明显狭窄且存在冠状动脉慢血流现象的患者95例为慢血流组,同期冠状动脉无明显狭窄且血流正常的患者100例为对照组。采用校正的TIMI血流计帧法(correctedTI-MIframecount,CTFC)检测,其中CTFC值>27诊断为冠状动脉慢血流。记录相关的临床资料进行多元Logistic回归分析。结果两组平均血流帧数比较,差异有统计学意义(P<0.01)。两组患者男性比例及BMI比较,差异均有统计学意义(P<0.05);两组白介素-6(IL-6)和B型钠尿肽(BNP)水平比较,差异均有统计学意义(P<0.05);而其他实验室检查指标比较,差异均无统计学意义(P>0.05)。两组冠状动脉扭曲系数和冠状动脉远端主要血管分支数比较,差异均有统计学意义(P<0.05)。多元Logistic回归分析结果示,男性、BMI、IL-6、冠状动脉扭曲系数和冠状动脉远端分支数与冠状动脉慢血流现象相关(P<0.05)。结论炎性因子和冠状动脉解剖因素与冠状动脉慢血流现象相关,其可能参与冠状动脉慢血流的发病机制。
Objective To investigate the clinical factors influencing the slow flow of coronary arteries and the anatomic factors of coronary arteries. Methods Selected from March 2008 to September 2009 due to suspected coronary heart disease in our hospital coronary angiography, the results showed no significant coronary artery stenosis and the presence of coronary artery slow flow in 95 patients with slow blood flow group, the same period 100 cases of coronary artery without obvious stenosis and normal blood flow were the control group. The corrected TIM-MI framecount (CTFC) was used to detect the CTFC value> 27, which was diagnosed as slow coronary flow. Record the relevant clinical data for multivariate logistic regression analysis. Results The average blood flow frames between the two groups, the difference was statistically significant (P <0.01). There were significant differences in the proportion of male and BMI between the two groups (P <0.05). The levels of interleukin 6 (IL-6) and B-type natriuretic peptide (BNP) P <0.05). However, there was no significant difference between the other laboratory indexes (P> 0.05). There were significant differences between the two groups in coronary artery torsion coefficient and distal coronary artery branches (P <0.05). Multivariate logistic regression analysis showed that male, BMI, IL-6, coronary artery torsion coefficient and distal coronary artery branch number were correlated with coronary flow (P <0.05). Conclusions Inflammatory factors and coronary artery anatomical factors are related to the phenomenon of slow blood flow in coronary arteries, which may be involved in the pathogenesis of slow blood flow in coronary arteries.