超声心动图评价左心功能低下冠心病患者冠状动脉旁路移植术后恢复研究  

Echocardiographic prediction of recovery after CABG in patients with left ventricular dysfunction

作　　者：于岩[1] 王辉山[1] 金岩[1] 赵洋[1] YU Yan;WANG Hui-shan;JIN Yan;ZHAO Yang(Department of Cardiac Surgery,The General Hospital of Shenyang Military Command,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院心血管外科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第10期1220-1222,共3页Clinical Journal of Medical Officers

基　　金：军队装备研制项目重大项目(ASY135001);辽宁省自然科学基金计划重点项目(20170540977)

摘　　要：目的探讨超声心动图评价左心功能低下的冠心病患者行冠状动脉旁路移植术(CABG)后恢复程度的价值。方法选取自沈阳军区总医院2015年间收治的206例单纯行CABG术的患者为研究对象,69例术后左室射血分数(LVEF)恢复正常(LVEF≥55%)的患者为A组,137例术后LVEF未恢复正常(40%≤LVEF≤50%)的患者为B组,比较并分析两组患者的临床资料,术后1年行超声心动图测量左房直径(LAD)、左室舒张末期内径(LVEDd)、左室收缩期内径(LVESd)、左室舒张末期容积(LVEDV)、室间隔厚度(IVS)、左室后壁厚度(LVPW)、E/Ea及左室Tei指数。结果两组患者的年龄、高血压、糖尿病、吸烟及高血脂情况比较,差异无统计学意义(P> 0. 05); B组患者的心肌梗死发生率高于A组,差异有统计学意义(P <0. 05)。两组患者的LAD、LVESd比较,差异无统计学意义(P> 0. 05); A组患者的LVEDd、LVEDV、E/Ea、左室Tei指数均低于B组,LVPW高于B组,差异有统计学意义(P <0. 05)。结论超声心动图评价冠心病患者行CABG术后预后不良安全可靠,重复性高,具有较高的诊断效果,防止左室扩大和LVEF降低对患者的预后至关重要。Objective To investigate the degree of recovery after coronary artery bypass grafting(CABG)in patients with coronary heart disease and left ventricular dysfunction.Methods A retrospective study was performed on 206 cases of patients who underwent CABG in 2015.Patients were divided into the normal LVEF group(LVEF≥55%,Group A,n=69)and the abnormal LVEF group(40%≤LVEF≤50%,Group B,n=137).Clinical data of the two groups were compared and analyzed.Echocardiography was performed 1 year after surgery to measure left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDd),left ventricular end-diastolic volume(LVEDV),left ventricular septal thickness(IVS),left ventricular posterior wall thickness(LVPW),E/Ea and left ventricular Tei index.Results There was no statistically significant difference in age,hypertension,diabetes,smoking and hyperlipidemia between the two groups(P>0.05).The incidence of myocardial infarction in Group B was higher than that in Group A,and the difference was statistically significant(P<0.05).There was no statistically significant difference in LAD and LVESd between the two groups(P>0.05).The index of LVEDd,LVEDV,E/Ea and left ventricular Tei in Group A were all lower than that in Group B,the index of LVPW in Group A was higher than that in Group B,and the difference was statistically significant(P<0.05).Conclusion Echocar diography was used to evaluate the poor prognosis of patients with coronary heart disease after CABG,which is safe,reliable,highly repetitive,and had a high diagnostic effect.Preventing left ventricular enlargement and reducing LVEF is crucial for improving the prognosis of patients with myocardial infarction.

关 键 词：超声心动图 左心功能减低 冠心病 冠状动脉旁路移植术 

分 类 号：R654.2[医药卫生—外科学]