利用压力-容积环评价不同冠脉病变冠心病病人的左心室功能  

The evaluation of left ventricular function by pressure-volume loop in patients with different extents of coronary stenosis

作　　者：富小红[1] 戴日静[2] 齐国先[1] 贾大林[1] 彭永文[1] 张斌[1] 李双玲 

机构地区：[1]中国医科大学附属第一临床学院心内科,沈阳110001 [2]营口市中心医院心内科,营口115002

出　　处：《中国介入心脏病学杂志》2001年第B12期57-60,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的　利用左室压力 容积环评价不同冠脉病变程度冠心病病人的左心室功能。方法　收集行冠脉及左室造影检查患者的临床与心导管检查资料共 6 5例 ,取右前斜位 30 (行左室造影 ,连续记录左心室与主动脉压力曲线 ,描点法测量左室容积 ,绘制心室压力 容积环 ,测量并计算压力 容积环所体现的各项心室能量指标。结果　正常心室压力 容积环位于坐标轴左下方 ,随冠脉狭窄程度加重 ,典型压力 容积环逐渐向右上方移位。射血分数在单、双支病变组无明显变化 ,在三支病变组降低 ;搏出功无明显变化 ;充盈能增大 ;心室总能量在双、三支病变组明显增大 ;收缩末势能逐渐增大 ;能量效率逐渐降低。结论　压力 容积环可在常规心室造影过程中获取 ,它能定量直观地反映多项心室功能指标。各心室能量指标在冠状动脉病变时发生相应的变化 。Objective To evaluate the left ventricular function in patients with different extents of coronary stenosis by the left ventricular pressure volume loop Methods In 65 patients who were undergoing coronary angiography and left ventriculography examinations, materials of clinical and cardiac catheter examinations were collected In right anterior oblique 30 degrees the left ventriculography was progressed The pressure curves of the left ventricle and the aorta were recorded continuously and volumes of the left ventricles were measured with the dot tracing method Pressure volume loop was set up and ventricular energy indexes embodied by the pressure volume loop were measured and calculated Results In normal group, pressure volume loop was located in the left and lower portion of the coordinate system Along with the levels of the coronary stenosis becoming more severe, pressure volume loops moved to the right and upper portion of the coordinate system Little changes occurred in ejection fraction except that there was a decreasing in patients with lesions of three branches; Stroke work showed no obvious changes; Filling energy became larger; Total energy increased obviously in both groups with lesions of double branches and three branches; End systolic energy increased gradually while energy efficiency decreased gradually Conclusion The ventricular pressure volume loop can be obtained in routine ventriculography which can reflect many indexes of ventricular function quantitatively The ventricular energy indexes change correspondingly with coronary artery lesions and may be useful to assess ventricular function in patients with different levels of coronary stenosis

关 键 词：压力-容积环 左室造影 左室功能 能量指标 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]