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背景目前有关平均血小板体积(MPV)、炎性标志物与冠状动脉痉挛之间的关系尚未清楚。目的评估冠状动脉痉挛与MPV及炎性标志物的相关性。方法选择2013年1月—2014年9月新疆医科大学第一附属医院住院冠状动脉造影显影正常但有胸痛的患者345例,静脉注射麦角新碱诱发冠状动脉痉挛,根据冠状动脉痉挛激发试验结果分为两组,痉挛组(60例)和无痉挛组(285例)。比较两组患者年龄、性别、吸烟、高血压、高脂血症、体质指数、C反应蛋白、白细胞计数(WBC)、中性粒细胞计数(PMN)、单核细胞计数(MO)、淋巴细胞计数(LY)、血小板计数(PLT)、MPV、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平。冠状动脉痉挛影响因素分析采用多因素Logsitic回归分析。结果痉挛组患者男性、吸烟率、高脂血症发生率、C反应蛋白水平、PMN、MO高于非痉挛组(P<0.05)。两组患者年龄、高血压发生率、体质指数、WBC、LY、MPV、TG、TC、LDL-C、HDL-C水平比较,差异无统计学意义(P>0.05)。多因素Logsitic回归分析结果显示,吸烟、PMN、MO与冠状动脉痉挛有回归关系(P<0.05)。结论炎性反应可能参与冠状动脉痉挛的病理生理过程,吸烟、PMN、MO异常可能是冠状动脉痉挛的危险因素,MPV可能与冠状动脉痉挛无关。
Background The current relationship between mean platelet volume (MPV), inflammatory markers and coronary artery spasm is unclear. Objective To evaluate the correlation between coronary artery spasm and MPV and inflammatory markers. Methods From January 2013 to September 2014, 345 patients with normal coronary angiography but with chest pain were admitted to the First Affiliated Hospital of Xinjiang Medical University. Coronary artery spasm was induced by intravenous ergometrine. According to the result of coronary artery spasm provocation test Two groups, spasticity group (60 cases) and no spasticity group (285 cases). Age, sex, smoking, hypertension, hyperlipidemia, body mass index, C-reactive protein, white blood cell count (WBC), neutrophil count (PMN), monocyte count (MO), lymphocyte (LY), platelet count (PLT), MPV, triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) Factors influencing coronary artery spasm were analyzed by multivariate logistic regression analysis. Results Male patients in spasm group had higher rates of smoking, hyperlipidemia, C-reactive protein, PMN and MO than those without spasm (P <0.05). There was no significant difference in age, the incidence of hypertension, body mass index, WBC, LY, MPV, TG, TC, LDL-C and HDL-C between the two groups (P> 0.05). Multivariate logistic regression analysis showed that smoking, PMN, MO and coronary artery spasm had a regression relationship (P <0.05). Conclusion The inflammatory reaction may be involved in the pathophysiology of coronary artery spasm. Abnormal smoking, PMN and MO may be the risk factors of coronary artery spasm. MPV may not be related to coronary artery spasm.