冠状动脉旁路移植术后近中期桥血管闭塞因素分析及心功能变化  

Factors of graft occlusion in short and medium terms and changes of heart function after coronary artery bypass grafting

作　　者：薛阳红 张国伟[1] Xue Yanghong;Zhang Guowei(Department of Cardiovascular Surgery,First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;不详)

机构地区：[1]哈尔滨医科大学附属第一医院心血管外科,哈尔滨150001

出　　处：《中国循证心血管医学杂志》2020年第8期979-983,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析桥血管近中期闭塞的因素及心功能变化。方法随访2012年9月至2016年11月于哈尔滨医科大学附属第一医院行冠状动脉(冠脉)旁路移植术患者172例,收集术后(1周左右)及复查时(术后3月至1年)临床资料,将患者分为通畅组和闭塞组,分析桥血管近中期闭塞的因素及患者心功能的变化。结果多因素回归分析,术后E/A值是桥血管闭塞的影响因素。组内比较,相较于术后,两组复查时左室舒张期内径(LVEDd)、射血分数(EF)值均增加,E/A值减小。组间比较,LVEDd、E/A、EF的变化值,两组间没有统计学差异。结论术后E/A值是冠脉旁路移植术近中期桥血管闭塞的影响因素。冠脉旁路移植术后患者近中期LVEDd还是会增大,舒张功能下降,但心脏收缩功能继续改善。近中期桥血管的部分闭塞不会影响患者整体心功能。Objective To analyze the factors of graft occlusion in short and medium terms and changes of heart function.Methods The patients(n=172)undergone coronary artery bypass grafting(CABG)were followed up who were chosen from the First Affiliated Hospital of Harbin Medical University from Sept.2012 to Nov.2016.The clinical materials were collected after CABG(for about 1 week)and during reexamination(after CABG from 3 months to 1 y).All patients were divided into unobstructed group and occluded group.The factors of graft occlusion in short and medium term and changes of heart function were analyzed.Results The results of multi-factor regression analysis showed that post-operation E/A ratio was an influence factor of graft occlusion.The comparison within groups showed that left ventricular end-diastolic inner diameter(LVEDd)and ejection fraction(EF)increased and E/A ratio decreased in 2 groups during reexamination compared with after CABG.The comparison between groups showed that there was no statistical difference in changes of LVEDd,E/A ratio and EF between 2 groups.Conclusion The post-operation E/A ratio is an influence factor of graft occlusion after CABG in short and medium terms.LVEDd will increase,cardiac diabolic function will decrease but cardiac systolic function will be improved after CABG in short and medium terms.The partial graft occlusion will not affect the global heart function in short and medium terms.

关 键 词：冠状动脉旁路移植术 桥血管闭塞 心功能 

分 类 号：R654.2[医药卫生—外科学]