稳定型缺血性心脏病患者与健康人左室功能及心肌损伤指标对比研究  

Comparative analysis of left ventricular function and myocardial injury markers in patients with stable ischaemic heart disease and healthy individual

作　　者：曾雅丽 ZENG Yali(Health Management Center,Sichuan University Wangjiang Hospital,Chengdu,Sichuan 610065,China)

机构地区：[1]四川大学望江医院健康管理中心,四川成都610065

出　　处：《影像研究与医学应用》2024年第15期16-20,25,共6页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨稳定型缺血性心脏病(SIHD)患者及健康对照组之间左室功能及心肌损伤指标的比较研究。方法:纳入2023年1月—12月在四川大学望江医院内科住院诊断为SIHD的患者75例。所有患者均进行了冠脉造影检查,其中53例显示至少1支冠脉病变,22例冠脉造影结果无异常。纳入同期30例健康人群为对照组。记录受检者的基本资料及心肌损伤等检验参数,采用超声心动图技术测量了左室基本功能及血流动力学参数。结果:与对照组相比,SIHD组的吸烟率、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、N末端脑钠肽前体(NT-ProBNP)均增高,差异有统计学意义(P<0.05)。与对照组相比,SIHD组的左心室后壁收缩末期厚度(LVPWds)、室间隔收缩末期厚度(IVSTs)、舒张晚期最大血流速度(VA)、E/舒张早期最大速度(Em)、左室舒张末期容积(LVEDV)及左室收缩末期容积(LVESV)增高,而二尖瓣口舒张早期最大血流速度(VE)、VE/VA、Em、舒张晚期最大速度(Am)、Em/Am、左室射血分数(LVEF)及左室每搏输出量(LVSV)均降低,差异有统计学意义(P<0.05)。SIHD造影狭窄组的吸烟率、臀围、收缩压、CK-MB及NT-ProBNP较造影正常组增高,差异有统计学意义(P<0.05)。与SIHD造影正常组相比,SIHD造影狭窄组的左心室收缩末期内径(LVESD)、左室舒张末期(LVEDD)、IVSTs、LVPWds、LVESV和LVEDV均增高,而VE/VA、Em均降低,差异有统计学意义(P<0.05)。结论:SIHD患者表现为左室舒张及收缩功能下降,心肌功能受损。无论是造影正常还是狭窄的SIHD患者,均存在心肌功能损害,包括心脏收缩功能和舒张功能障碍。Objective This study aims to compare left ventricular function and myocardial injury indexes between patients with stable ischemic heart disease(SIHD)and healthy.Methods 75 patients diagnosed with SIHD,admitted to the Department of Internal Medicine at Sichuan University Wangjiang Hospital from January to December 2023,were included.Coronary angiography was performed on all patients,with 53 showing lesions in at least one coronary artery and 22 having normal coronary angiographic findings.Additionally,30 healthy controls were recruited.Detailed demographic data and test parameters such as myocardial injury were recorded.Basic left ventricular function and hemodynamic parameters were assessed using echocardiographic techniques.Results Compared with the control group,the smoking rate,total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),extremely low density lipoprotein cholesterol(VLDL-C),cardiac troponin I(cTnI),creatine kinase isoenzyme MB(CK-MB),and N-terminal brain natriuretic peptide precursor(NT ProBNP)in the SIHD group were all increased,and the differences were statistically significant(P<0.05).Compared with the control group,the left ventricular posterior wall end systolic thickness(LVPWds),interventricular septal end systolic thickness(IVSTs),late diastolic maximum blood flow velocity(VA),E/early diastolic maximum velocity(Em),left ventricular end diastolic volume(LVEDV),and left ventricular end systolic volume(LVESV)in the SIHD group increased,while the mitral valve opening early diastolic maximum blood flow velocity(VE),VE/VA,Em,late diastolic maximum velocity(Am),Em/Am,left ventricular ejection fraction(LVEF),and left ventricular stroke output(LVSV)all decreased significantly(P<0.05).The smoking rate,hip circumference,systolic blood pressure,CK-MB,and NT ProBNP in the SIHD imaging stenosis group were higher than those in the normal imaging group,and the differences were statistically significant(P<0.05).Compared with the normal group of SIHD imaging,the left ventricular end systolic diamete

关 键 词：稳定型缺血性心脏病 冠状动脉造影 左室收缩功能 左室舒张功能 CTNI CK-MB 

分 类 号：R445.1[医药卫生—影像医学与核医学]