| Objective: To explore a smoking history of the change of vascularendothelial cell function in patients with coronary heart disease,smoking evaluation effect on vascular endothelial function in patientswith coronary heart disease, the research of this experiment. Thisexperiment through the inclusion of patients with coronary heart disease,coronary heart disease patients with no history of smoking on admissiontest routine inspection (blood, urine routine, blood sugar, bloodelectrolyte, total cholesterol, triglycerides, high-density lipoproteincholesterol, low density lipoprotein cholesterol, uric acid, myocardialenzymes), C-reactive protein, allergic C-reactive protein and the useof high resolution doppler ultrasound instrument foreign perivascular(brachial artery) detection, including the measurement of flow mediatedbrachial artery diastolic reaction (flow-mediated dilation, FMD) andnitroglycerin mediated brachial artery diastolic reaction (nitroglycerin-mediated dilation, NMD) for evaluation index. In the evaluation ofsmoking on the vascular endothelial cell function of patients withcoronary heart disease (CHD) and to explore the application of noninvasive high-resolution doppler ultrasound instrument technology todescribe the change of vascular endothelial cell function.Methods: From August2011to January2014in China-Japan unionhospital of JiLin university90patients with coronary heart disease(CHD), which has a history of smoking patients (check out the standardaverage daily smoking big five, up to5years)50people, patients withsmoking history)(excluding secondhand smoke40people, the twogroups of patients, respectively defined as smoking group and thecontrol group, patients were randomly assigned in the group. Hospitalroutine inspection by blood tests (blood, urine routine, blood sugar,blood electrolyte, total cholesterol, triglycerides, high-densitylipoprotein cholesterol, low density lipoprotein cholesterol, uric acid,myocardial enzymes), C-reactive protein examination, allergic C-reactive protein examination, using high resolution doppler ultrasoundforeign perivascular (brachial artery) for testing. The former vein bybedside determination of whole blood; Which adopts Celermajaeroperation method, the specific operation method is: tell the subjects ofsupine after10minutes rest below quiet condition,2cm on the rightelbow application probe to detect brachial artery, observe the appearanceof brachial artery and to measure the diameter (D0), then put the blood pressure cuff is tied at the upper right elbow10centimeters, air pressureand systolic blood pressure, about50mm hg pressure again, fiveminutes after deflated,60seconds after the vent in the same place thesame method is used to measure the brachial artery diameter (D1); Makepatients with quiet state of rest for15minutes again, basis of brachialartery diameter recovery value (D0), told the sublingual contains0.5mgnitroglycerin tablet, and again after5min measuring brachial arterydiameter (D2). To draw a flow mediated brachial artery diastolicreaction (FMD) and nitroglycerin mediated brachial artery diastolicreaction (NMD), respectively, the diameter of the congestion after valuerelative to the percentage of the base diameter value coefficient.Computation formula is as follows: FMD=[(D1-D0)/D0] x100%,NMD=[(D2-D0)/D0] x100%. High resolution doppler ultrasonictesting is aimed at testing of brachial artery of brachial artery endothelialfunction. Two groups of data comparison analysis using statisticalinspection.Result:(1) admission examination of routine blood tests, no obviousdifference was found between two groups.(2) exsanguinate assay CRP examination: smoking group5.5±1.4 mg/L, the control group plus or minus3.9±0.8mg/L, no differencebetween the two groups to compare.Allergic CRP smoking group was7.32±4.67， the control group2.25±1.79, comparing the two groupshave significant difference (P <0.01), there is clinical significance， thatis allergic CRP changes have correlation with vasxcular endothelialcell function with Smoking patients；(3) D0measured value: smoking group was3.54±0.51mm, thecontrol group was3.56±0.54, the more similar between the two groupshave no obvious difference;(4) the FMD: smoking group was (8.73±2.87%) and control group(19.32±2.67％), smoking set of FMD coefficient difference comparedwith control group, xsigxnificant (P <0.05)，Smxoking damage vascularendothelial function expression in endothelial dependent vasodilationfunction；(5) the NMD: smoking group was (19.68±5.84%), non-smokinggroup (24.24±4.13%), is no obxvious difference between the two groups(P>0.05).Conclusions:Smoke damage vascular endoxthelial function in patients withcoronary heart disease, expression in endxothelial dependent vasodilation function；Smoking patients with coronary heart disease (CHD) allergic CRPchanges have correlation with vascular endothelial cell function. |
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