Wang Yong, Jia Peng-Yu, Chen Bao-Jun, Chen Yan, Yu Hang, Yu Yao, Yang Hui-Min, Jia Da-Lin, Ma Chun-Yan
Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, China.
Cardiology. 2017;138(3):141-146. doi: 10.1159/000460239. Epub 2017 Jun 27.
It has been reported that coronary slow flow (CSF) is associated with acute myocardial infarction, ventricular tachycardia, ventricular fibrillation, and even sudden cardiac death. Although studies concerning the etiopathogenesis of CSF are scarce, diffuse atherosclerosis and endothelial dysfunction are thought to play important roles. It has been suggested that a high plasma thrombomodulin (TM) level seems to play an important role in the pathogenesis of atherosclerosis and endothelial dysfunction.
We hypothesized that a high plasma TM level might be associated with CSF and aimed to research the relationship between plasma TM level and CSF.
Fifty-two CSF patients with angiographically proven CSF and 44 cases with normal coronary flow were included in this study. Coronary flow velocity was determined by the thrombolysis in myocardial infarction (TIMI) frame count method. Plasma TM levels were measured in all the study subjects.
Plasma TM levels were significantly higher in the CSF group compared to the control group (3.9 ± 0.5 vs. 3.6 ± 0.3 ng/mL, p = 0.01). There was a positive relationship (r = 0.31, p = 0.002) between plasma TM level and mean TIMI frame count (TFC). Factors associated with mean TFC were plasma TM level (β = 0.206, p = 0.038) and red cell distribution width (β = 0.088, p = 0.009) in multiple linear regression analysis.
Patients with CSF have a higher plasma TM level, and this may play an important role in the pathogenesis of CSF. An elevated plasma TM level may be a predictor of CSF. Future studies are needed to confirm these results.
据报道，冠状动脉慢血流（CSF）与急性心肌梗死、室性心动过速、心室颤动甚至心源性猝死相关。尽管关于CSF病因发病机制的研究较少，但弥漫性动脉粥样硬化和内皮功能障碍被认为起重要作用。有人提出，高血浆血栓调节蛋白（TM）水平似乎在动脉粥样硬化和内皮功能障碍的发病机制中起重要作用。
我们假设高血浆TM水平可能与CSF有关，并旨在研究血浆TM水平与CSF之间的关系。
本研究纳入了52例经血管造影证实为CSF的患者和44例冠状动脉血流正常的患者。采用心肌梗死溶栓（TIMI）帧数法测定冠状动脉血流速度。在所有研究对象中测量血浆TM水平。
与对照组相比，CSF组的血浆TM水平显著更高（3.9±0.5 vs. 3.6±0.3 ng/mL，p = 0.01）。血浆TM水平与平均TIMI帧数（TFC）之间存在正相关关系（r = 0.31，p = 0.002）。在多元线性回归分析中，与平均TFC相关的因素是血浆TM水平（β = 0.206，p = 0.038）和红细胞分布宽度（β = 0.088，p = 0.009）。
CSF患者的血浆TM水平较高，这可能在CSF的发病机制中起重要作用。血浆TM水平升高可能是CSF的一个预测指标。需要进一步的研究来证实这些结果。
