冠状动脉病变程度与左室舒张功能关系  

Relationship between Severity of Coronary Heart Disease and Left Ventricular Diastolic Function

作　　者：付晓葆[1,2] 吴永全[2] 王宏宇[1] 刘金波[1] 连艳凯[2] 

机构地区：[1]北京大学首钢医院血管医学科,北京100141 [2]首都医科大学附属北京友谊医院心血管中心,北京100050

出　　处：《中国医药导刊》2015年第3期224-226,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:观察冠心病(CHD)患者冠状动脉病变程度与左室舒张功能之间的关系。方法:81例疑诊CHD行冠脉造影并且左室射血分数正常的患者分为CHD组(56例)和对照组(25例)。冠状动脉造影前行左室压力记录测定左室舒张末期压力(LVEDP),CHD患者行Gensini积分评估冠脉病变程度。结果:CHD组患糖尿病、高血压比例高于对照组,LVEDP较对照组升高(P=0.005)。对包括糖尿病、高血压、LVEDP在内的参数行多元Logistic回归,结果显示两组间LVEDP差别仍然有统计学意义(P=0.039)。CHD患者Gensini积分≥100组LVEDP明显高于<50组(P=0.032),CHD三支病变组LVEDP同单支病变组相比明显升高(P=0.023)。Pearson单因素相关分析显示LVEDP与冠状动脉Gensini积分成正相关(r=0.355,P=0.007)。结论:射血分数正常的CHD患者左室舒张功能受损,并随冠脉病变范围和程度增加而恶化。Objective： To observe the relationship between the severity of coronary artery disease and left ventricular diastolic function in patients with coronary heart disease （CHD）.Methods：81 patients with suspected CHD undergoing coronary angiography and normal left ventricular ejection fraction were divided into CHD group （56 cases） and control group （25 cases）. Left ventricular end diastolic pressure （LVEDP） based on left ventricular pressure recording before coronary angiography and Gensini score assessing for the severity of coronary artery stenosis in CHD patients were measured.Results：In CHD group, the prevalence of diabetes and hypertension was higher than that of the control group, LVEDP was higher than the control group （P=0.005）. The result of multiple Logistic regression, including diabetes, hypertension and LVEDP, showed it remain significant difference in LVEDP （P=0.039） between two groups （P=0.039）. LVEDP in group of Gensini score≥100 was significantly higher than that in group of Gensini score〈50 （P=0.032）, LVEDP is obviously higher in group of three vascular obstructive than one vascular obstructive （P=0.023）. Single factor analysis showed LVEDP was positively correlated with Gensini score （r=0.355,P=0.007）.Conclusion：Left ventricular diastolic function was impaired and associated with the extent and severity of coronary artery stenosis in CHD patients with normal ejection fraction.

关 键 词：冠心病 左室舒张功能 GENSINI积分 左室舒张末压力 

分 类 号：R541.4[医药卫生—心血管疾病]