冠状动脉狭窄程度与左心功能的相关性研究  

Study on the relationship between the stenosis of coronary and left ventricular cardiac function

作　　者：鲁晶[1] 王连生[2] 贾恩志[2] 雍永宏[2] 王晖[2] 朱铁兵[2] 杨志健[2] 许迪[2] 陈莉[2] 

机构地区：[1]姜堰市人民医院心内科,江苏姜堰225500 [2]南京医科大学第一附属医院心内科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2008年第8期1007-1010,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金资助(30400173)

摘　　要：目的:探讨冠状动脉狭窄程度与左心功能的关系。方法:对拟诊冠心病的117例患者(其中男性91例,女性26例)进行血压、血脂、心脏超声等检查,并行冠状动脉造影检查,采用Gensini评分系统对冠状动脉血管病变程度进行定量评分,得出Gensini积分,统计分析冠状动脉狭窄程度与左心功能的关系。结果:由低至高Gensini积分四分位分组后,患者的舒张压(diastolic blood pressure,DBP)、左房内径(left atrial dimension,LAD)、左室舒张末径(LVDd)、左室收缩末径(left ventricular end systolic dimension,LVDs)、左室短轴缩短率(fraction shortening,FS)、左室射血分数(left ventricular ejection fraction,LVEF)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)在不同Gensini积分组间差异有显著性(P<0.05)。Gensini评分与各变量间Spearman相关性比较:LAD(R=0.341,P=0.000),LVDd(R=0.373,P=0.000),LVDs(R=0.399,P=0.000)与Gensini积分呈显著正相关;FS(R=-0.298,P=0.001),LVEF(R=-0.320,P=0.000),HDL-C(R=-0.276,P=0.003)与Gensini积分呈显著负相关。Gensini评分与各参数的多元线性回归分析,LVDs和DBP与冠脉狭窄程度的积分呈独立相关,LVDs和DBP是Gensini积分的独立影响因子。结论:LVEF及FS与冠状动脉病变的程度呈负相关,对冠心病的病变程度具有预测价值。Objective：To investigate the correlation between the stenosis degree of coronary and the left ventricular cardiac dysfunction. Methods：The coronary stenosis degree were analyzed retrospectively on 117 patients（male 91, female 26） by angiography. The parameters of blood pressure, serum lipid and echocardiography were observed. According to Gensini＇s score, the correlation between the stenosis degree of coronary and cardiac dysfunction were analyzed. Results： When Gensini＇ s score level was examined as a categorical variable ordering by quartile values. There were significant differences in diastolic blood pressure （DBP）（P = 0.019）, left atrial dimension（LAD） （P = 0.003） ,left ventricular end diastolic dimension（LVDd） （P = 0.000） ,left ventricular end systolic dimension （LVDs） （P = 0.000）, fraction shortening（FS）（P = 0.001 ）, left ventricular ejection fraction（LVEF）（P = 0.000） and HDL-C（P = 0.016） among the groups with different Gensini＇s scores. Compared Gensini＇s scores with Spearman, Gensini＇s score was positively correlated with LAD （R = 0.341 ,P = 0.000）,LVDd （R = 0.373,P = 0.000） and LVDs （R = 0.399,P = 0.000）,respectively. Gensini＇s score was negatively correlated with FS（R = -0.298,P = 0.001）,LVEF（R = -0.320,P = 0.000） and HDL-C（R = -0.276,P = 0.003）. By the multiple linear regression between the Gensini＇s score and paramenters,LVDs and DBP ,were independently associated with the scores of the stenosis degree of coronary. LVDs and DBP were independently associated with Gensini＇ s score. Conclusion： LVEF and FS were negatively correlated with the stenosis degree of coronary and independent from other tradiovascular risk factors.

关 键 词：冠状动脉 狭窄 左心功能 相关性 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]