冠心病患者左室舒张功能与左室缺血面积的相关性研究  

Correlation between left ventricular diastolic function and left ventricular ischemic area in patients with coronary heart disease

作　　者：何雅文 唐梁思成 李斌斌 刘巧志 吴奇 潘德锋 He Yawen;Tang Liangsicheng;Li Binbin;Liu Qiaozhi;Wu Qi;Pan Defeng(Department of Cardiology,Affiliated Hospital of Xuzhou Medical University,Xu Zhou 221000,China;不详)

机构地区：[1]徐州医科大学附属医院心内科,徐州221000

出　　处：《中国循证心血管医学杂志》2022年第2期217-219,223,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的采用门控心肌灌注显像评估冠状动脉粥样硬化性心脏病(冠心病)患者左室缺血面积与左室舒张功能相关性。方法收集2018年1月至2020年9月于徐州医科大学附属医院接受心肌灌注显像和心血池显像的187例患者,根据心肌灌注显像结果分为冠心病组138例和对照组49例。比较两组患者的一般临床资料(包括年龄、性别、体质指数,合并症有无高血压、糖尿病)、E/A比值、超声心动图指标差异、心功能指标差异。分析冠心病组患者E/A比值与运动灌注缺陷总分(SSS)及心功能指标之间的相关性。结果对照组和冠心病组患高血压比例和糖尿病比例、E/A比值、高峰充盈率(PFR)、前1/3充盈分数(1/3FF)、平均充盈率(MFR)、左室舒张末期容积(EDV)、左室收缩末期容积(ESV)比较差异有统计学意义(P<0.05)。经门控心肌灌注显像得到的冠心病组患者SSS、PFR、1/3FF、MFR、EDV、ESV与E/A比值有良好的相关性(SSS:r=0.262,P=0.002;PFR:r=0.414,P<0.001;1/3FF:r=0.339,P<0.001;MFR:r=0.243,P=0.004;EDV:r=0.292,P=0.001;ESV:r=0.311,P<0.001),其中SSS与E/A比值呈正相关,SSS越高,左室舒张障碍程度越重。结论门控心肌灌注显像可有效评估冠心病患者左室舒张功能;冠心病心肌缺血面积是影响左室舒张功能障碍的危险因素。Objective To review the correlation between left ventricular ischemic area and left ventricular diastolic function by using gated myocardial perfusion imaging(GMPI)in patients with coronary heart disease(CHD).Methods CHD patients(n=187)were chosen from the Affiliated Hospital of Xuzhou Medical University from Jan.2018 to Sept.2020,and they were divided,according to GMPI results,into CHD group(n=138)and control group(n=49).The general clinical materials(including age,sex,BMI and complications of hypertension or diabetes),E/A ratio,and difference in echocardiography indexes and heart function were compared between 2 groups.The correlation among E/A ratio,summed stress score(SSS)and indexes of heart function were analyzed in CHD group.Results The difference in percentages of hypertension and diabetes,E/A ratio,peak filling rate(PFR),top 1/3 filling fraction(1/3FF),mean filling rate(MFR),left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)had statistical significance between 2 groups(P<0.05).In CHD group,SSS,PFR,1/3FF,MFR,LVEDV and LVESV obtained by GMPI were closely correlated to E/A ratio(SSS:r=0.262,P=0.002;PFR:r=0.414,P<0.001;1/3FF:r=0.339,P<0.001;MFR:r=0.243,P=0.004;EDV:r=0.292,P=0.001;ESV:r=0.311,P<0.001),and SSS was positively correlated to E/A ratio.The higher the SSS,the severer the severity of left ventricular diastolic disorder.Conclusion GMPI can effectively review the left ventricular diastolic function in CHD patients.The myocardial ischemic area of CHD is a risk factor of left ventricular diastolic disorder.

关 键 词：冠心病 左室舒张功能 缺血面积 运动灌注缺陷总分 

分 类 号：R541.4[医药卫生—心血管疾病]