北京生物醫(yī)學(xué)工程

疑似冠心病患者冠狀動(dòng)脈慢血流現(xiàn)象相關(guān)危險(xiǎn)因素的Meta分析

Risk factors associated with slow coronary flow in suspected coronary heart disease patients：a Meta-analysis

作者：楊印龍張宏輝喬愛科

單位：北京工業(yè)大學(xué)環(huán)境與生命學(xué)部(北京 100124)<br />智能化生理測(cè)量與臨床轉(zhuǎn)化北京市國(guó)際科技合作基地(北京 100124)<br />通信作者：?jiǎn)虗劭疲淌凇-mail: [email protected]

關(guān)鍵詞：冠狀動(dòng)脈慢血流；危險(xiǎn)因素；Meta分析

分類號(hào)：R318

出版年·卷·期（頁碼）：2022·41·6（603-610）

摘要：

目的系統(tǒng)評(píng)價(jià)疑似冠心病患者冠狀動(dòng)脈慢血流現(xiàn)象的影響因素，為指導(dǎo)臨床診治與冠脈血流動(dòng)力學(xué)研究提供依據(jù)。方法檢索PubMed、Web of Science、The Cochrane Libraray、CNKI、萬方數(shù)據(jù)庫中關(guān)于疑似冠心病患者發(fā)生冠狀動(dòng)脈慢血流現(xiàn)象發(fā)生危險(xiǎn)因素相關(guān)病例-對(duì)照研究，使用Revman5.4軟件對(duì)符合納入標(biāo)準(zhǔn)的研究資料進(jìn)行Meta 分析和異質(zhì)性檢驗(yàn)。結(jié)果共納入19篇文獻(xiàn)累計(jì)病例2 597例，對(duì)照2 342例，包括中文12 篇，英文7篇，納入研究為基于人群的橫斷面研究或病例對(duì)照研究。排除異質(zhì)性高的因素后共納入14項(xiàng)危險(xiǎn)因素，Meta分析結(jié)果顯示：男性［OR=1.43，95%CI(1.09, 1.87)，P= 0.009］、紅細(xì)胞計(jì)數(shù)［MD=0.45，95%CI(0.23，0.68)，P＜0.0001］、紅細(xì)胞壓積［MD=3.45，95%CI(2.38，4.52)，P＜0.001］、血小板平均體積［MD=0.46，95%CI(0.06，0.86)，P= 0.02］、血尿酸［SMD=1.58，95%CI(0.39，2.76)，P= 0.009］、同型半胱氨酸［SMD=2.54，95%CI(1.50，3.58)，P＜0.001］、高密度脂蛋白［SMD=-0.76，95%CI(-1.12，-0.39)，P＜0.001］，等因素均有統(tǒng)計(jì)學(xué)差異(P＜0.05)。結(jié)論根據(jù)現(xiàn)有證據(jù)，男性、紅細(xì)胞計(jì)數(shù)、紅細(xì)胞壓積、血小板平均體積、血尿酸、同型半胱氨酸為CSF現(xiàn)象危險(xiǎn)因子，高密度脂蛋白是CSF現(xiàn)象發(fā)生的獨(dú)立保護(hù)因子。

Objective To systematically evaluate the risk factors of slow coronary blood flow in suspected CHD patients and provide a basis for clinical diagnosis and coronary hemodynamics research. Methods We searched PubMed, Web of Science, The Cochrane Libraray, CNKI and WanFang Data from inception to September 1st 2020 to collect case-control studies about slow coronary flow in suspected CHD patients. Meta -analysis and heterogeneity test were performed for the included studies using RevMan 5.4 software. Results Nineteen studies involving 2 597 CSF patients and 2 342 controls were finally included, including 12 in Chinese and 7 in English. The included studies were population-based cross-sectional studies or case-control studies. A total of 14 risk factors were included after the exclusion of factors with high heterogeneity. The results of Meta -analysis showed that: male (OR=1.43, 95%CI 1.09 to 1.87, P= 0.009), red blood count (MD=0.45, 95%CI 0.23 to 0.68, P < 0.000 1), hematocrit (MD=3.45, 95%CI 2.38 to 4.52, P < 0.001), mean platelet volume (MD=0.46, 95%CI 0.06 to 0.86, P= 0.02), serum uric acid (SMD=1.58, 95%CI 0.39 to 2.76, P= 0.009), homocysteine (SMD=2.54, 95%CI 1.50 to 3.58, P < 0.001),high-density lipoprotein (SMD=-0.76, 95%CI -1.12 to -0.39, P < 0.001), the difference was statistically significant (P < 0.05). Conclusions Based on the existing evidence, the risk factors of slow coronary blood flow in suspected CHD patients include male, red blood cell count, hematocrit, mean platelet volume, serum uric acid, homocysteine and high density lipoprotein is an independent protective factor. The results showed that male patients, intravascular inflammatory response and blood viscosity were important factors affecting slow coronary flow.

參考文獻(xiàn)：

[1] Tambe AA, Demany MA, Zimmerman HA, et al. Angina pectoris and slow flow velocity of dye in coronary arteries--a new angiographic finding[J]. American Heart Journal, 1972, 84(1): 66-71.
[2] Mangieri E, Macchiarelli G, Ciavolella M, et al. Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries[J]. Catheterization and Cardiovascular Diagnosis, 1996, 37(4): 375-381.
[3] Hawkins BM, Stavrakis S, Rousan TA, et al. Coronary slow flow—prevalence and clinical correlations[J]. Circulation Journal, 2012, 76(4): 936-942.
[4] Lo CK, Mertz D, Loeb M, et al. Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments [J]. BMC Medical Research Methodology, 2014,14: 45.
[5] 趙子威, 楊杰, 劉妍,等. 冠狀動(dòng)脈慢血流的相關(guān)危險(xiǎn)因素分析[J]. 中國(guó)醫(yī)藥, 2020, 15(7): 1004-1007.
Zhao ZW, Yang J, Liu Y, et al. Risk factors of coronary slow flow[J]. China Medicine, 2020, 15(7): 1004-1007.
[6] 姚彥鵬, 余小華, 毛啟兄,等. 低氧血癥對(duì)西藏高原地區(qū)藏族患者冠狀動(dòng)脈慢血流現(xiàn)象的影響[J]. 中國(guó)心血管雜志, 2020, 25(2):146-150.
Yao YP, Yu XH, Mao QX, et al. Effects of hypoxemia on coronary slow flow in Tibetan patients in Tibet Plateau[J]. Chinese Journal of Cardiovascular Medicine, 2020, 25(2):146-150.
[7] 張錦濤, 李琴, 王喬. 影響冠狀動(dòng)脈造影患者冠狀動(dòng)脈慢血流的相關(guān)危險(xiǎn)因素[J]. 解放軍預(yù)防醫(yī)學(xué)雜志, 2019, 37(3): 4-6.
[8] 謝偉. 冠狀動(dòng)脈慢血流現(xiàn)象相關(guān)危險(xiǎn)因素分析[D]. 蕪湖：皖南醫(yī)學(xué)院, 2019.
Xie W. Analysis of risk factors related to coronary slow flow phenomenon[D]. Wuhu: Wannan Medical College, 2019.
[9] 王雷. 血小板體積指標(biāo)與冠狀動(dòng)脈慢血流現(xiàn)象的臨床研究[D]. 濱州: 濱州醫(yī)學(xué)院, 2018.
Wang L. A clinical study on the relationship between platelet volume indices and slow coronary flow phenomenon[D]. Binzhou: Binzhou Medical University, 2018.
[10] 夏開. 冠狀動(dòng)脈慢血流現(xiàn)象的相關(guān)危險(xiǎn)因素的研究分析[D]. 鄭州: 鄭州大學(xué), 2017.
Xia K. The related risk factors for coronary slow flow phenomenon of research and analysis[D]. Zhengzhou: Zhengzhou University, 2017.
[11] 王帥, 薛強(qiáng), 劉毅, 等. 大樣本冠狀動(dòng)脈慢血流的相關(guān)因素分析[J]. 心臟雜志, 2017, 29(2): 180-183.?
[12] 梁有峰. 冠心病患者血清趨化因子CXCL9水平及其與冠狀動(dòng)脈慢血流關(guān)系的研究[D]. 合肥：安徽醫(yī)科大學(xué), 2017.
Liang YF. Roles of serum CXC chemokines in coronary atherosclerotic heart disease and coronary slow flow phenomenon[D]. Hefei: Anhui Medical University, 2017.
[13] 張娟, 王彩鳳. 血漿同型半胱氨酸水平與冠狀動(dòng)脈慢血流的相關(guān)性分析[J]. 疾病監(jiān)測(cè)與控制, 2016, 10(8): 636-637.
[14] 郝云濤. PNN50與冠狀動(dòng)脈慢血流現(xiàn)象相關(guān)性研究[D]. 鄭州: 鄭州大學(xué), 2016.
Hao YT. The correlation between PNN50 and the coronary slow flow phenomenon[D]. Zhengzhou: Zhengzhou University, 2016.
[15] 袁曉旭. 冠狀動(dòng)脈慢血流與脈搏波傳導(dǎo)速度的相關(guān)性分析[D]. 福州: 福建醫(yī)科大學(xué), 2014.
Yuan XX. The relation between the pulse wave velocity and coronary slow flow[D]. Fuzhou: Fujian Medical University, 2014.
[16] 劉桂清. 冠脈慢血流患者的脈搏波傳導(dǎo)速度和踝臂指數(shù)的變化及意義[J]. 中國(guó)醫(yī)學(xué)創(chuàng)新, 2014(8): 33-34, 35.
Liu GQ. Changes and significances of pulse wave velocity and ankle brachial index in patients with coronary slow flow[J]. Medical Innovation of China, 2014(8): 33-34,35.
[17] Ding YD, Pei YQ, Wang R, et al. Increased plasma lipoprotein-associated phospholipase A2 levels are associated with coronary slow flow[J]. BMC Cardiovascular Disorders, 2020, 20: 248.?
[18] Yilmaz M, Da?li MN, Uku ?, et al. Focusing on a complete blood cell parameter: mean platelet volume levels may be a predictor of coronary slow flow[J]. Vascular Health and Risk Management, 2017,13: 255-261.
[19] Yang S, Wang DZ, Zhang HX, et al. Echo-tracking technology assessment of carotid artery stiffness in patients with coronary slow flow[J]. Ultrasound in Medicine and Biology, 2015,41(1): 72-76.?
[20] Yang WW, Wang YH, Yu YX, et al. Establishing normal reference value of carotid ultrafast pulse wave velocity and evaluating changes on coronary slow flow[J]. The International Journal of Cardiovascular Imaging, 2020, 36(10): 1931-1939.
[21] Ozyurtlu F, Yavuz V, Cetin N, et al. The association between coronary slow flow and platelet distribution width among patients with stable angina pectoris[J]. Postepy W Kardiologii Interwencyjnej, 2014,10(3): 161-165.
[22] Bilgi M, Güllü H, Kozano?lu I, et al. Evaluation of blood rheology in patients with coronary slow flow or non-obstructive coronary artery disease[J]. Clinical Hemorheology and Microcirculation, 2013, 53(4): 317-326.
[23] Yilmaz H, Demir I, Uyar Z. Clinical and coronary angiographic characteristics of patients with coronary slow flow[J]. Acta Cardiologica, 2008,63(5): 579-584.?
[24] 徐新娟，孫理華. 冠狀動(dòng)脈慢血流相關(guān)因素分析[J]. 心血管康復(fù)醫(yī)學(xué)雜志, 2010, 19(3): 247-250.
[25] Hawkins BM, Stavrakis S, Rousan TA, et al. Coronary slow flow—prevalence and clinical correlations[J]. Circulation Journal, 2012, 76(4): 936-942.
[26] Beltrame JF, Limaye SB, Horowitz JD. The coronary slow flow phenomenon a new coronary microvascular disorder[J]. Cardiology, 2002, 97: 197-202．
[27] Sanghvi S, Mathur R, Baroopal A, et al. Clinical, demographic, risk factor and angiographic profile of coronary slow low phenomenon: a single centre experience[J]. Indian Heart Journal, 2018, 70 (Suppl 3): S290-S294.
[28] Li Y, Fang F, Ma N, et al. Feasibility study of transthoracic echocardiography for coronary slow flow phenomenon evaluation: validation by coronary angiography[J]. Microcirculation, 2016, 23(4): 277-282.
[29] De Bruyne B, Hersbach F, Pijls NH, et al. Abnormal epicardial coronary resistance in patients with diffuse atherosclerosis but “normal” coronary angiography[J]. Circulation, 2001, 104(20): 2401–2406.
[30] Yamashina A, Tomiyama H, Arai T, et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk[J]. Hypertension Research, 2003, 26(8): 615-622.

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