完全闭塞病变侧支循环的形成与相关左心功能的研究  

Study on the Formation of Collateral Circulation and Correlated Left Cardiac Function in Total Coronary Occlusion

作　　者：赵茹[1] 孙根义[1] 张静霞[1] 刘玉洁[1] 陈刚[1] 萧健勇[1] 高明东[1] 

机构地区：[1]天津市胸科医院心内科,300051

出　　处：《天津医药》2004年第12期743-745,共3页Tianjin Medical Journal

摘　　要：目的 :评价完全闭塞病变侧支循环形成影响因素及侧支循环与左室功能的关系。方法 :根据侧支循环形成情况 ,将 16 5例经冠状动脉造影证实至少有 1支主要冠状动脉完全闭塞的患者分为A组 (79例 ,侧支循环 0～ 1级 )和B组 (86例 ,侧支循环 2～ 3级 ) ,左室造影测定左室射血分数、左室舒张末压和节段室壁运动进行左心功能分析 ,并将临床特点加以对照研究 ,侧支循环的评价采用Rentrop分级法。结果 :A组心肌梗死史、糖尿病史、室壁瘤形成均高于B组 (P <0 .0 5 ) ,A组左室射血分数明显低于B组 ,室壁运动积分、左室舒张末压明显高于B组 (P <0 .0 1)。结论 :完全闭塞病变中良好侧支循环的建立对左心功能有保护作用 ,糖尿病影响侧支循环形成。Objective: To evaluate the affected factors of the formation of collateral circulation, and the relation between collateral circulation and left cardiac function in total coronary occlusion. Methods:One hundred and sixty-five patients with chronic occlusion of a major coronary artery at least confirmed by PCI (duration>2 weeks) were divided into two groups which included 79 patients with collateral circulation grade 0～1 in group A, and 86 patients with collateral circulation grade 2～3 in group B. The left ventricular ejection fraction, left ventricular end-diastolic pressure and left ventricular wall motion cortina score were assessed, and were compared with clinical features. The collateral circulation was evaluated by Rentrop grading. Results: The incidence of diabetes, myocardial infarction, and ventricular aneurysm were higher in group A compared with those in group B (P< 0.05). The Left ventricular ejection fraction was significantly lower in group A.The left ventricular wall motion Cortina score and left ventricular end-diastolic pressure of patients in group A were obviously higher than that in group B (P<0.01). Conclusion: Well-developed collateral circulation could preserve left ventricular function in patients with total coronary occlusion. Diabetes mellitus can affect the formation of collateral circulation.

关 键 词：完全闭塞病变 侧支循环 左心功能 舒张末压 射血分数 冠状动脉闭塞 

分 类 号：R543[医药卫生—心血管疾病] R541[医药卫生—内科学]