高原冠心病冠状动脉病变及左心功能的CT研究  

CT evaluation of coronary artery lesion and cardiac function in patients with coronary heart disease at high altitude

作　　者：张永海[1] 孙艳秋[1] 白峻虎[1] 杨梅[1] 王学玲[1] 汪静静[1] 

机构地区：[1]青海省人民医院CT室,青海西宁810000

出　　处：《实用放射学杂志》2016年第11期1749-1751,1758,共4页Journal of Practical Radiology

基　　金：青海省自然科学基金项目（2011-Z-738）.

摘　　要：目的探讨高原地区冠心病冠状动脉病变特点及左心功能变化规律。方法选取世居高原的冠心病200例，分别测量左冠状动脉主干及各段分支、右冠状动脉主干及分支的管径（非狭窄段）、评估冠状动脉重构，计算心功能指标每搏输出量（SV）、射血分数（EF）值和左室游离壁中段的增厚率，按冠状动脉狭窄部位程度及性别、年龄匹配选取平原冠心病200例做对照分析。结果高原冠心病组冠状动脉近端（非狭窄段）平均直径较平原组小；高原组较平原组冠状动脉正性重构率高、负性重构率低，并有统计学差异；高原冠心病SV、EF值及左室游离侧壁中段平均室壁增厚率较平原冠心病组大。结论高原冠心病冠状动脉病变正性重构率高，左心室功能受累较轻。Objective To explore the characteristics of coronary artery lesion and changes of left ventricular function in patients with coronary heart disease in plateau. Methods 200 patients in altitude and 200 age, gender, degree of coronary stenosis matched patients lived at sea-level selected as control group with CAD were enrolled in our study. Coronary computed tomographic angiogra- phy {CCTA） examination was conducted for two groups. We measured the diameters of left main coronary artery, right coronary artery and distal branches. The indexes reflecting cardiac function such as stroke volume （SV） and ejection fraction （EF} and the thicken- ing of left ventricular free wall at end-systolic phase （TLVWEP） were assessed respectively, and the coronary artery remodeling was evaluated. Results There were significant differences between the patients in plateau and the patients in sea-level, there was less the average diameter of proximal coronary artery; higher the positive remodeling rate and lower negative remodeling rate. In addition, the patients in plateau had higher left cardiac EF,SV and TLVWEP than that the patients in sea-level. Conclusion The coronary artery lesion and heart function of patients with coronary heart disease in plateau has its own characteristics, its coronary positive rate of refactoring is high and the left cardiac involvement is lighter.

关 键 词：高原 冠状动脉 左心室功能 计算机体层成像 血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学]