| objective:To investigate the relationship among PWV/ABI and the degree of coronary artery pathological changes, inflammation such as high sensitivity C reactive protein (Hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) in patients with coronary heart disease.Methods:The study is in the way of control, single-blind, conditions match the group and non-random.1.Subjects of study:180 patients with coronary artery disease or doubted coronary artery disease were in the Department of Cardiology, Affiliated Hospital of Luzhou Medical College from 2009,3 to 2010,3.These cases included male 104 and female 76 with the age 40-85 years. Excluding subjects:patients with main artery inflammation, rheumatological disease, Infection, cancer, renal insufficiency, hyperthyroidism, liver failure and so on.2. To measure patient index:the patients under-went coronary angiography, measured PWV/ABI, serum high sensitivity C reactive protein (Hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a), glucose, total cholesterol, triglyceride (TG), low density lipoprotein (LDL), etc before coronary angiography, recorded patient age, sex, blood pressure and smoking. 3. The score of coronary artery pathological changes in group of study subjects were performed with gensini score on the degree of coronary artery pathological changes after coronary angiography. According to the score,the patients were divided into no, mild, moderate, and severe pathological changes group. According to the number of coronary artery pathological changes, the patients were divided into 0,1,2,3 coronary artery pathological changes group. According to whether being pathological changes, the patients were divided into being pathological changes and non pathological changes group. According to whether PWV is normal or not, the patients were divided into normal PWV and abnormal PWV group. According to whether ABI is normal or not, the patients were divided into normal ABI and abnormal ABI group. Each group were selected from 180 patients,140 cases eligible for the study, furthermore, risk factors for coronary heart disease in each group matched.4. Data statistical analysis:SPSS13.0 package used. All data are shown as mean±standard deviation (x±s). Between the two groups using independent sample t test, multiple groups comparing with the single factor analysis of variance, multiple comparison between groups using LSD method, constitute using x2 test, interdependent relationship between the two groups using regression and linear correlation analysis, determined significant differences with P<0.05. Results:1. Comparing in groups of varying pathological change degrees. PWV:No pathological changes group and the mild pathological changes group was no significant difference (P=0.18), comparing other two groups were significantly different (P<0.05), PWV in mild pathological changes group was 1367±142 (cm/s), PWV in severe pathological changes group was 1830±144 (cm/s), PWV was positively correlated with the integral, linear regression and correlation analysis R=0.779, P<0.01; ABI:ABI between no pathological changes group and the mild pathological changes group was no significant difference (P=0.447), comparing other two groups were significantly different (P<0.05), ABI in mild pathological changes group was 1.10±0.06, ABI in severe pathological changes group was 0.85±0.05, ABI was negatively correlated with the integral, linear regression and correlation analysis R=-0.868, P<0.01; Hs-CRP:comparing two in groups were significantly different (P <0.05),Hs-CRP in mild pathological changes group was 3.62±0.71(mg/L), Hs-CRP in severe pathological changes group was 7.68±2.07(mg/L), Hs-CRP was positively correlated with the integral, linear regression and correlation analysis R=0.684, P<0.01; IL-6:comparing two in groups were significantly different (P< 0.05), IL-6 in mild pathological changes group was 82.3±11.0(ng/L), IL-6 in severe pathological changes group was 161.9±30.3 (ng/L), IL-6 was positively correlated with the integral, linear regression and correlation analysis R=0.91, P<0.01; TNF-α:TNF-αbetween mild pathological changes group and moderate pathological changes group was no significant difference (P=0.400), comparing other two in groups were significantly different (P<0.05), TNF-ain mild pathological changes group was 1903±946(ng/L), TNF-αin severe pathological changes group was 2557±1022(ng/L), TNF-αwas positively correlated with the integral, linear regression and correlation analysis R=0.403, P<0.01.2. Comparing in groups of varying number of coronary artery pathological changes. PWV:PWV between 0 and 1 coronary artery pathological changes group was no significant difference (P=0.375), between 1 and 2 coronary artery pathological changes group was no significant difference (P=0.054), comparing other two in groups were significantly different (P<0.05), PWV in 3 coronary artery pathological changes group was 1837±87(cm/s); ABI:ABI between 0 and 1 coronary artery pathological changes group was no significant difference (P=0.655), between 0 and 2 coronary artery pathological changes group was no significant difference (P=0.252), between 1 and 2 coronary artery pathological changes group was no significant difference (P=0.101), comparing other two in groups were significantly different (P<0.05), ABI in 3 coronary artery pathological changes group was 1.01±0.16; Hs-CRP:Hs-CRP between 0 and 1 coronary artery pathological changes group was no significant difference (P=0.963), comparing other two in groups were significantly different (P<0.05), Hs-CRP in 3 coronary artery pathological changes group was 7.40±2.81(mg/L); IL-6: IL-6 between 0 and 1 coronary artery pathological changes group was no significant difference (P=0.227), comparing other two in groups were significantly different (P<0.05), IL-6 in 3 coronary artery pathological changes group was 163.5±39.6(ng/L); TNF-α:TNF-αbetween 1 and 2 coronary artery pathological changes group was no significant difference (P=0.687), comparing other two in groups were significantly different (P<0.05), TNF-ain 3 coronary artery pathological changes group was 2587±822 (ng/L). 3.Comparing being pathological changes group with non pathological changes one. PWV,ABI,Hs-CRP,IL-6,TNF-αbetween being pathological changes and non pathological changes group were significantly different (P<0.05).4. Comparing Hs-CRP,IL-6,TNF-αbetween normal PWV and abnormal PWV group. Hs-CRP,IL-6,TNF-abetween normal PWV and abnormal PWV group were significantly different (P<0.05). Hs-CRP in normal PWV group was 1.37±0.77(mg/L), Hs-CRP in abnormal PWV group was 5.97±5.39(mg/L), Hs-CRP was positively correlated with PWV, linear regression and correlation analysis R=0.573, P<0.01; IL-6 in normal PWV group was 49.1±30.1(ng/L), IL-6 in abnormal PWV group was 77.2±55.5(ng/L), IL-6 was positively correlated with PWV, linear regression and correlation analysis R=0.387, P< 0.01; TNF-αin normal PWV group was 1063±343(ng/L), in abnormal PWV group was 1517±668(ng/L), TNF-αwas positively correlated with PWV, linear regression and correlation analysis R=0.327 p<0.01.5. Comparing Hs-CRP,IL-6,TNF-αbetween normal ABI and abnormal ABI group. Hs-CRP,IL-6,TNF-αbetween normal ABI and abnormal ABI group were significantly different (P<0.05). Hs-CRP in normal ABI group was 3.54±2.14(mg/L), in abnormal ABI group was 5.43±3.51 (mg/L), Hs-CRP was negatively correlated with ABI, linear regression and correlation analysis R=-0.478,P=0.018; IL-6 in normal ABI group was 84.3±24.2(ng/L), in abnormal ABI group was 127.1±32.0(ng/L), IL-6 was negatively correlated with ABI, linear regression and correlation analysis R=-0.61,P<0.01; TNF-ain normal ABI group was 1406.8±625.6(ng/L), in abnormal ABI group was 2312.0±663.8(ng/L), TNF-αwas negatively correlated with ABI, linear regression and correlation analysis R=-0.395 P=0.031. Conclusion:1. PWV is closely related with the degree of coronary artery disease, PWV close to 1400 (cm/L), the coronary artery tends to be pathological changes, PWV is greater than 1800 (cm/L), the coronary prone to serious disease, PWV is positively correlated with the degree of coronary artery pathological changes and can predict severity of coronary artery pathological changes.2. ABI closely associated with coronary artery disease. When ABI is less than 1.10, the coronary artery prone to disease,and lower than 0.85, serious disease. ABI is negatively correlated with the degree of coronary artery pathological changes and can predict severity of coronary artery pathological changes.3. Inflammatory factors are closely related to coronary artery disease. When patients Hs-CRP is up to 3.6 (mg/L), IL-6 80 (ng/L), TNF-α1900 (ng/L), the coronary artery prone to disease. When patients Hs-CRP is up to 7.5(mg/L), IL-6160 (ng/L), TNF-a2500 (ng/L), the coronary artery prone to serious disease. Inflammatory factors is positively correlated with the integral of coronary artery pathological changes and can be used to detect and predict the coronary disease.4. PWV is closely related to inflammatory factors and positively correlated with it,they can reflect each other. When PWV is greater than normal, the concentrations of inflammatory cytokines increase. When the Hs-CRP close to 6.0 (mg/L), IL-6 is greater than 80 (ng/L), TNF-a is greater than 1500 (ng/L), PWV increases, suggesting arterial stiffness increased.5. ABI is closely related with the inflammatory cytokines.When ABI is lower than normal, the concentrations of inflammatory cytokines increase. When the Hs-CRP is up to 5.4 (mg/L), IL-6127 (ng/L), TNF-a 2300 (ng/L), ABI is lower than normal, suggesting the possibility of arterial stenosis increased.6. PWV, ABI and inflammatory factors in patients with artery disease and non-artery disease are significantly different.7. PWV, ABI and serum concentrations of inflammatory cytokines can not predict 0, 1,and 2 coronary artery disease, but can predict 3 coronary artery disease. When PWV is greater than 1800 (cm/L) and ABI less than 1.0, it is more possible that being 3 coronary artery disease.8. Inflammatory cytokines is significant for predicting three 3 coronary artery disease. when the Hs-CRP is greater than 7.4 (mg/L), IL-6 160 (ng/L), TNF-αis near to 2600 (ng/L), it is more possible that being 3 coronary artery disease.9.It is more objective and better show the disease situation that assess the degree of coronary artery pathological changes using gensini score than using the number of coronary artery pathological changes.
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