血流储备分数评价心肌缺血与左心室舒张功能关系的研究  

Relationship Between Myocardial Ischemia and Left Ventricular Diastolic Function by Fractional Flow Reserve Evaluation in Patients With Coronary Artery Disease

作　　者：谢伟[1] 邱洪 刘俊明[1] 杨伟宪 李科[1] 任凤波 邹琦[1] 赵亮[1] 李娜[1] 

机构地区：[1]新疆生产建设兵团医院心血管内二科,新疆维吾尔自治区乌鲁木齐市830002 [2]中国医学科学院、北京协和医院、阜外心血管病医院

出　　处：《中国循环杂志》2014年第11期884-887,共4页Chinese Circulation Journal

基　　金：兵团科技攻关计划课题项目(2012BA039)

摘　　要：目的：探讨应用血流储备分数（FFR）评价心肌缺血对左心室舒张功能的影响。方法：纳入因胸痛拟诊断冠心病或确诊冠心病并冠状动脉（冠脉）造影显示左冠状动脉支配心肌区域的冠心病患者57例，即冠脉血管主支单处狭窄临界病变（狭窄范围50％。70％；直径〈2．5mm定义为无效血管）。所有患者均行心肌FFR的测量。根据FFR值分为实验组（FFR〈0．80，27例）和对照组（FFR≥0．80，30例）。比较两组患者一般情况及影响左心室舒张功能的危险因素，同时比较两组患者的超声心动图评价指标如左心室舒张末期内径、左心房内径、左心室射血分数以及舒张早期二尖瓣血流频谱E峰与二尖瓣环e、峰的比值（E／e、洧无差异。结果：实验组与对照组患者在性别、年龄、高血压、糖尿病、胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、随机血糖等方面差异均无统计学意义（P均〉0．05）；实验组患者的左心室舒张末期内径、左心房内径、左心室充盈压的指标E／e值大于对照组（P〈O．05），实验组患者的左心室射血分数小于对照组（P〈O．05），差异均有统计学意义。结论：冠心病对早期舒张功能的影响取决于心肌功能性缺血。Objective： To explore the relationship between myocardial ischemia and left ventricular diastolic function （LVDF） by fractional flow reserve （FFR） evaluation in patients with coronary artery disease （CAD）. Methods： A total of 57 patients with chest pain were studied, the diagnosis of CAD was confirmed by coronary angiography, which indicated 50%-70% of coronary stenosis. All patients received FFR examination and they were divided into 2 groups： Experimental group, the patients with FFR〈0.80, n=27 and Control group, the patients with FFR〉0.80, n=30. The basic condition and risk factors affecting LVDF were compared between 2 groups. Echocardiography was conducted for evaluating left ventricular end-diastolic dimension （LVEDD）, left atrial dimension （LAD）, left ventricular ejection fraction （LVEF） and E/e＇ value in both groups. Results： The patients＇ gender, age, history of hypertension, diabetes, blood levels of cholesterol, TG, LDL-C, HDL-C and glucose were similar between 2 groups, P〉0.05. Compared with Control group, the Experimental group had the increased LVEDD, LAD and E/e＇ value and decreased LVEF, all P〈0.05. Conclusion： The impact of CAD on early diastolic function depends on functional myocardial ischemia in relevant patients.

关 键 词：冠心病 左心室舒张功能 冠状动脉造影 血流储备分数 

分 类 号：R54[医药卫生—心血管疾病]