The Application Analysis Of The Index Of Microcirculatory Resistance In Patients With Angina Pectoris

Objective:To explore the influencing factors of the index of microcirculatory resistance(IMR)in patients with angina pectoris,and try to come up with a sensitive index of the prevention and treatment of microcirculation dysfunction in patients with angina pectoris.Methods:A total of 81 patients who were measured the IMR and diagnosed with angina pectoris in the cardiology department of the second people's hospital of yunnan province were retrospectively selected from December 2014 to March 2017.First,we took routine coronary angiography exams,then we used the pressure-temperature guide wire technique to measure the IMR of target artery.According to the level of IMR we set up two groups for these 81 patients.Group A(IMR<25),and Group B(IMR?25).Next,we collected all 81 patients' data which includes sex,age,height,weight,smoking history,alcohol history,blood pressure,diabetes mellitus,blood lipid,uric acid,creatinine,the degree of coronary artery stenosis,aneurysmal dilatation,TIMI blood flow(thrombolysis in myocardial infarction flow,TIMI flow).At last,using statistical software to screen for predictors that led to an increase in IMR by comparing the differences in clinical factors between the two groups.Results:1.The measurement of IMR using the pressure-temperature guide wire technique is safe,simple,reproducible,specific and unacted on the stenosis of epicardial blood vessels.The success rate of this operation was high,and all the patients did not have surgical complications.2.The results showed that two groups had significant difference in levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),low density lipoprotein cholesterol(LDL-C)and low density lipoprotein cholesterol(LDL-C),smoking,slow coronary flow or no coronary reflow(SCF/NR),diabetes mellitus,the degree of coronary artery stenosis(P<0.05).However,there were no significant differences in gender,age,body mass index(BMI),alcohol,hypertension,uric acid,creatinine and aneurysmal dilatation(P>0.05).3.Two categories of logistic regression analysis showed that SCF/NR,diabetes mellitus and smoking were left in the equation at last,and the regression coefficient was positive.The corresponding OR values were all>1.SCF/NR(B=0.82,OR=2.27,P<0.001),Diabetes mellitus(B=0.21,OR=1.23,P=0.003),Smoking(B=0.18,OR=1.06,P=0.004).It shows that SCF/NR,diabetes mellitus,Smoking were the independent risk factors of the increase of IMR,which means SCF/NR,diabetes,and smoking were independent risk factors of coronary microcirculation dysfuction.Conclusions:1.The measurement of IMR is an easy,safe,reproducible and high specificity way to assess the coronary microcirculation.2.In patients with angina pectoris,microcirculation dysfuction was significantly correlated with TC,TG,LDL-C,SCF/NR,smoking,diabetes mellitus and the degree of coronary artery stenosis.3.In patients with angina pectoris,SCF/NR,diabetes,smoking is an independent risk factor for coronary microcirculation dysfuction.