| 郑媛媛,叶 莎,张倩榕,丁铭格,金爱萍.一氧化氮、血清尾加压素Ⅱ与老年稳定型心绞痛患者冠脉粥样硬化斑块的关系及对功能性心肌缺血的预测[J].,2023,(16):3123-3128 |
| 一氧化氮、血清尾加压素Ⅱ与老年稳定型心绞痛患者冠脉粥样硬化斑块的关系及对功能性心肌缺血的预测 |
| Relationship between Nitric Oxide, Serum Urotensin Ⅱ and Coronary Atherosclerotic Plaque in Elderly Patients with Stable Angina Pectoris and Prediction of Functional Myocardial Ischemia |
| 投稿时间：2023-01-07 修订日期：2023-01-31 |
| DOI：10.13241/j.cnki.pmb.2023.16.024 |
| 中文关键词: NO UⅡ 冠心病 稳定型心绞痛 冠状动脉粥样硬化 |
| 英文关键词: Nitric oxide Serum urotensin Ⅱ Coronary heart disease Stable angina pectoris Atherosclerosis |
| 基金项目:陕西省重点研发计划项目（2021SF-141） |
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| 中文摘要: |
| 摘要 目的：探讨一氧化氮（NO）、血清尾加压素Ⅱ（UⅡ）与老年稳定型心绞痛患者冠脉粥样硬化斑块的关系及对功能性心肌缺血的预测。方法：选取我院2020年10月到2022年12月收治的120例老年稳定型心绞痛患者作为研究对象，回顾性分析所有患者CT造影诊断结果，依照动脉狭窄程度将患者分为不稳定斑块组（n=35），稳定斑块组（n=46）和无斑块组（n=39）。对比三组患者NO、UⅡ表达水平，并分析其与老年稳定型心绞痛患者冠脉粥样硬化斑块的相关性。所有患者均采取保守治疗，将治疗后出现功能性心肌缺血的40例患者分为心肌缺血组，将其余80例患者分为非心肌缺血组，对比两组患者临床一般情况和NO、UⅡ，并分析NO、UⅡ对功能性心肌缺血的预测价值。结果：不稳定斑块组NO低于稳定斑块组和无斑块组、UⅡ水平高于稳定斑块组和无斑块组（P＜0.05），且稳定斑块组与无斑块组对比差异显著（P＜0.05）；Spearman相关分析结果显示：NO、UⅡ与老年稳定型心绞痛患者冠脉粥样硬化斑块稳定程度具有相关性（P<0.05）；心肌缺血组和非心肌缺血组患者性别、年龄、BMI、合并糖尿病、高血压、左心室射血分数、高脂血症情况对比无明显差异（P＞0.05），心肌缺血组和非心肌缺血组患者心功能分级、合并陈旧性心肌梗死、NO、UⅡ水平对比差异显著（P＜0.05）；最终logistic回归分析结果显示：NO、UⅡ升高是老年稳定型心绞痛患者功能性心肌缺血的独立影响因素（P＜0.05）。结论：NO、UⅡ与老年稳定型心绞痛患者冠脉粥样硬化斑块稳定程度具有明显关系，且通过NO、UⅡ水平可预测患者功能性心肌缺血的发生，因此临床上对于NO、UⅡ升高的老年稳定型心绞痛患者需及时调整治疗措施，进一步预防患者治疗后出现的功能性心肌缺血现象。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between nitric oxide, serum urotensin Ⅱ and coronary atherosclerotic plaque in elderly patients with stable angina pectoris, and to predict functional myocardial ischemia. Methods: 120 elderly patients with stable angina pectoris admitted to our hospital from October 2020 to December 2022 were selected as the study objects. The CT angiography diagnosis results of all patients were retrospectively analyzed. The patients were divided into unstable plaque group (n=35), stable plaque group (n=46) and non plaque group (n=39) according to the degree of arterial stenosis. The expression levels of nitric oxide and serum urotensin Ⅱ in the three groups were compared, and the correlation between them and coronary atherosclerotic plaque in elderly patients with stable angina pectoris was analyzed. All patients were treated conservatively. Forty patients with functional myocardial ischemia after treatment were divided into myocardial ischemia group, and the remaining 80 patients were divided into non myocardial ischemia group. The clinical general conditions, nitric oxide and serum urotensin Ⅱ of the two groups were compared, and the predictive value of nitrogen monoxide and serum urotensin Ⅱ on functional myocardial ischemia was analyzed. Results: The NO in the unstable plaque group was lower than that in the stable plaque group and the no-plaque group, and the U II level was higher than that in the stable plaque group and the no-plaque group(P<0.05), and the difference between the stable plaque group and the no-plaque group was significant (P<0.05); Spearman correlation analysis showed that NO and UII correlated with the degree of coronary atherosclerotic plaque stability in elderly patients with stable angina; There was no significant difference between the myocardial ischemia and non-myocardial ischemia groups in terms of gender, age, BMI, combined diabetes mellitus, hypertension, left ventricular ejection fraction, and hyperlipidemia (P>0.05), and significant difference between the myocardial ischemia and non-myocardial ischemia groups in terms of cardiac function classification, combined old myocardial infarction, NO, and U II levels (P<0.05); The final logistic regression analysis showed that the increase of nitric oxide and serum urotensin Ⅱ were independent influencing factors of functional myocardial ischemia in elderly patients with stable angina pectoris(P<0.05). Conclusion: Nitric oxide and serum urotensin Ⅱ have obvious relationship with the stability of coronary atherosclerotic plaque in elderly patients with stable angina pectoris, and the level of nitric oxide and serum urotensin Ⅱ can predict the occurrence of functional myocardial ischemia in patients. Therefore, it is necessary to timely adjust the treatment measures for elderly patients with stable angina pectoris who have elevated nitric oxide and serum urotensin Ⅱ, To further prevent functional myocardial ischemia after treatment. |
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