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目的:探讨血浆内皮素1(ET-1)、Toll样受体4(TLR-4)与冠状动脉慢血流的关系。方法:入选2014-01-2015-07于本院行冠状动脉造影的39例冠状动脉慢血流患者为试验组,同期冠状动脉造影正常的40例患者为对照组,采用酶联免疫吸附法(ELISA)测定两组患者血浆ET-1、TLR-4水平。结果:两组平均血流帧数的差异有统计学意义(P<0.001);冠状动脉慢血流患者中男性比例(79%)远大于女性;两组平均红细胞血红蛋白浓度(MCHC)、红细胞分布宽度变异系数(RDW-CV)、ET-1、TLR-4之间的差异有统计学意义(均P<0.05),其他实验室指标的差异无统计学意义。多因素logistic回归分析示ET-1、TLR-4与冠状动脉慢血流独立相关(均P<0.05);ET-1与TLR-4的Spearman相关系数为0.439(P<0.001),TLR-4与MCHC的Spearman相关系数为0.277(P=0.014),提示TLR-4与ET-1、MCHC显著相关,但相关关系并不密切(r<0.5)。结论:ET-1、TLR-4以及红细胞变形可能参与了冠状动脉慢血流的发生、发展。
Objective: To investigate the relationship between plasma endothelin-1 (ET-1), toll-like receptor 4 (TLR-4) and coronary artery slow blood flow. Methods: Forty-nine patients with coronary arterial slow flow who underwent coronary angiography in our hospital from January 2014 to January 2015 were selected as the experimental group. Forty patients with normal coronary angiography during the same period were selected as the control group, ELISA) was used to measure plasma ET-1 and TLR-4 levels in both groups. Results: There was a significant difference between the two groups in the average number of blood flow frames (P <0.001). The proportion of male patients with slow coronary artery flow (79%) was much larger than that of women. The mean red blood cell hemoglobin concentration (MCHC) The differences of RDW-CV, ET-1 and TLR-4 between the two groups were statistically significant (all P <0.05). There was no significant difference in other laboratory indexes. Multivariate logistic regression analysis showed that ET-1 and TLR-4 were independently associated with slow coronary flow (all P <0.05); Spearman correlation coefficients of ET-1 and TLR-4 were 0.439 Spearman’s correlation coefficient with MCHC was 0.277 (P = 0.014), suggesting that TLR-4 was significantly associated with ET-1 and MCHC, but the correlation was not close (r <0.5). Conclusion: ET-1, TLR-4 and erythrocyte degeneration may be involved in the occurrence and development of slow coronary flow.