侧支循环对前降支单支病变冠心病PCI手术患者心脏功能影响的研究  

Study on the effect of collateral circulation on cardiac function in patients receiving percutaneous coronary intervention( PCI) for lesions in single left anterior descending artery

作　　者：王微[1] 孟亮[1] 田志鹏[1] 赵鑫[1] 

机构地区：[1]沈阳医学院附属中心医院循环内科,辽宁沈阳110024

出　　处：《临床和实验医学杂志》2015年第8期647-650,共4页Journal of Clinical and Experimental Medicine

基　　金：沈阳医学院青年基金课题(编号20112058)

摘　　要：目的探讨侧支循环对前降支单支病变冠心病经皮冠脉介入术(PCI)手术患者心脏功能的影响。方法回顾性分析2012年1月至2014年6月期间收治的284例前降支单支病变且行PCI手术的冠心病患者,根据冠脉造影结果分为无侧支循环组(A组,Rentrop0级,n=150)及存在侧支循环组(B组,Rentrop1、2、3级,n=134),根据侧支循环的来源将134例患者分为同侧组(B1组,n=20)、对侧组(B2组,n=91)、同侧+对侧组(B3组,n=23)。比较各组的术后即刻、术后1个月、3个月、6个月的左室舒张末内径(LVEDD)、左室收缩末内径(LVEDS)、左室射血分数(LVEF)、舒张早期二尖瓣最大流速与心房收缩期二尖瓣最大流速的比值(E/A),以及血浆脑钠肽(BNP)的水平。结果术后全部患者的心功能均有所改善,但B组的LVEDD、LVESD、BNP显著低于A组(P<0.05),LVEF与E/A显著高于A组(P<0.05)。在B组内,B3组术后的心功能最佳,其次是B2组,B1组的术后心功能最差。结论侧支循环可以显著改善前降支单支病变冠心病患者PCI手术后的心功能,且同侧+对侧侧支循环的患者的心功能恢复程度最佳,其次是对侧侧支循环,同侧侧支循环最差。Objective To explore the effect of establishment of collateral circulation on cardiac function in patients receiving percutaneous coronary intervention（ PCI） for treatment of lesions in single left anterior descending artery. Methods The clinical data of 284 patients receiving PCI for treatment of lesions in single left anterior descending artery during January 2012 to June 2014 were retrospectively analyzed. These patients were divided into without collateral circulation group（ group A,Rentrop grade 0,n = 150） and collateral circulation group（ group B,Rentrop grades 1,2 and 3,n = 134） according to the results of coronary angiography. The above- mentioned 134 patients were further divided into insilateral group（ group B1,n = 20）,contralateral group（ group B2,n = 91） and insilateral ＋ contralateral group（ group B3,n = 23） according to the source of collateral circulation. LVEDD,LVEDS,LVEF,E / A and plasma level of BNP were compared among all these groups immediately,1month,3 and 6 months after operation. Results Postoperative cardiac function in all patients had been improved,but LVEDD,LVESD and plasma level of BNP in patients of group B were significantly lower than those of patients in group A（ P〈0. 05）,while LVEF and E / A were significantly higher than those of patients in group A（ P〈0. 05）. Among patients in group B,postoperative cardiac function of patients in group B3 was the best,followed by patients in group B2,and that of patients in group B1 was the worst. Conclusion The establishment of collateral circulation can significantly improve the cardiac function of patients receiving PC intervention in a single left anterior descending artery. Postoperative cardiac function of patients with insilateral ＋ contralateral collateral circulation is the best,followed by cases with contralateral collateral circulation. The postoperative cardiac function in patients with insilateral collateral circulation is the worst.

关 键 词：PCI 侧支循环 心功能 前降支 

分 类 号：R541.4[医药卫生—心血管疾病]