侧支循环对完全闭塞的冠状动脉病变择期经皮冠状动脉腔内介入术的心功能预测  

The predictive value of coronary collateral circulation in patients with one or more coronary artery occlusion undergoing elective percutaneous coronary intervention

作　　者：王世超[1] 武越[1] 张纯全[1] 刘玉昊[1] 邵一兵[1] 许文亮[1] 王旭[1] 

机构地区：[1]青岛大学医学院附属青岛市立医院东院心内科,266071

出　　处：《心肺血管病杂志》2016年第4期256-259,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的：探讨侧支循环对完全闭塞的冠状动脉病变,择期行经皮冠状动脉腔内介入术（PCI）的预测价值。方法：选择错过时间窗至少有1支或以上冠状动脉完全闭塞的患者102例,根据冠状动脉造影结果,按照Rentrop分级法将102例患者分为两组,侧支循环形成良好组（A组,Rentrop=2~3级,57例）和侧支循环形成不良组（B组,Rentrop=1~2级,45例）,比较两组患者PCI前后左心室舒张末容积内径（LVEDD）、左心室射血分数（LVEF）等的改善情况。结果：PCI术后侧支循环形成良好组的左心室射血分数（LVEF）较PCI前明显增加,差异有统计学意义（P〈0.05）。PCI术后侧支循环形成不良组的左心室舒张末容积内径（LVEDD）较PCI前明显增加,差异有统计学意义（P〈0.05）;PCI术前：两组间LVEF差异有统计学意义（P〈0.01）,PCI术后3个月：两组LVEDD、LVEF差异有统计学意义（P〈0.01）。结论：良好的侧支循环对左心功能有显著的保护作用,择期行PCI术则可以明显改善具有良好侧支循环的冠状动脉闭塞患者的预后。Objective： To investigate the predictive value of coronary collateral circulation in patients with one or more coronary artery occlusion who to choose a good day for PCI operation. Methods： 102 patients with one or more coronary artery occlusion who underwent coronary angiography and Rentrop＇s method were divided into 2 groups： Good collateral circulation（ A groups,Rentrop score 2- 3,n = 57） and（ B groups,Rentrop score1- 2,n = 45）,observed differences of LVEDD（ left ventricular end-diastolic volume） LVEF（ left ventricular ejection fraction） for PCI preoperative and postoperative. Results： Good collateral circulation group：Postoperative PCI left ventricular ejection fraction（ LVEF） were significantly higher than preoperative PCI,the difference was statistically significant（ P〈0. 05）. Poor collateral circulation group： Postoperative PCI left ventricular end diastolic volume index（ LVEDD）,increased significantly compared with that before PCI,the difference was statistically significant（ P〈0. 05）; Preoperative PCI： Comparison of good collateral circulation group and collateral circulation adverse group： The difference of LVEF between the two groups was statistically significant（ P〈0. 01）,PCI after 3 months： The difference of LVEDD and LVEF between the two groups was statistically significant（ P〈0. 01）. Conclusion： Good collateral circulation has a significant protective effect on left ventricular function,PCI operation can significantly improve the prognosis of patients with good collateral circulation of coronary artery occlusion.

关 键 词：侧支循环 完全闭塞冠状动脉 经皮冠状动脉腔内介入术 左心室舒张末容积内径 左心室射血分数 

分 类 号：R54[医药卫生—心血管疾病]