左房扩大在冠心病舒张性心力衰竭中的临床意义  

Clinical significance of left atrium enlargement in coronary heart disease patients with diastolic heart failure

作　　者：杨玉霞[1] 杨丽霞[1] 齐峰[1] 郭传明[1] 石燕昆[1] 魏玲[1] 王燕[1] 

机构地区：[1]成都军区昆明总医院心内科,云南昆明650032

出　　处：《心脏杂志》2006年第4期445-446,450,共3页Chinese Heart Journal

摘　　要：目的对冠心病舒张性心力衰竭患者左房内径变化及其临床意义进行研究。方法用彩色多普勒超声心动图仪测定44例冠心病舒张性心力衰竭(DHF组)患者左房内径(LAD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左心室射血分数(LVEF)、E峰、A峰及E/A比值,并与30例冠心病心功能正常者(对照组)比较。结果DHF组左房内径(34±5)mm较对照组(28±4)mm显著增加(P<0.01),左房内径扩大者(>30 mm)36例,占80%。DHF组中,E/A>1(假性正常化)患者LAD(36±10)mm较E/A<1患者LAD(33±5)mm增加,但无统计学差异。DHF组E/A值的高低与NYHA心功能分级相关性不明显,左房扩大程度与心功能分级相关性也不明显。结论DHF患者存在左房扩大,左房扩大是舒张性心功能不全病情发展的标志。AIM To explore the alteration and its significance of left atrium enlargment in coronary heart disease patients （CHD） with diastolic heart failure （DHF）. METHODS We examined the left atrium diameter（LAD）, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （ LVESV）, left ventricular eject fraction （ LVEF）, and the ratio （E/A） of the early filling phase peak of transmitral flow velocity （ peak E of TMF） with the late diastolic filling phase peak transmitral flow velocity （peak A of TMF） by echocardiograph in 44 CHD patients with DHF and 30 CHD patients without DHF. RESULTS LAD （34 ± 5 ）mm increased in CHD patients with DHF and enlarged left atrium was present in 80% of these patients. Those patients with E/A 〉 1 （pseudonormal） had larger LAD（36± 10） mm than that（33 ± 5 ）mm of those patients with E/A 〈 1, but the difference was not obvious. There was no relationship between the increasing or decreasing of the ratio of E/A and the classification of left ventricular function. CONCLUSION LAD is increased in CHD patients with DHF and LA enlargement may be one marker of the development of diastolic heart failure.

关 键 词：冠状动脉疾病 心力衰竭 舒张性 左心房扩大 

分 类 号：R541.6[医药卫生—心血管疾病]