冠心病患者冠状动脉病变程度与心功能关系的临床研究

目的 探讨冠状动脉粥样硬化性心脏病(简称冠心病)患者冠状动脉病变程度与心功能的关系.方法 选该院因胸痛住院拟诊为冠心病并择期拟行冠状动脉造影的患者90例.于造影前行无创血流动力检测.根据冠状动脉造影结果,显示冠状动脉有狭窄的患者74例作为疾病组,另选造影结果显示冠状动脉无狭窄并排除其他系统疾病及该院体检中心健康体检者30例作为对照组.将疾病组患者按照冠状动脉造影结果采用Gensini评分系统对冠状动脉病变程度进行量化评分,根据评分结果,分为2组:高分组(Gensini积分大于20分,40例),低分组(Gensini积分小于或等于20分,34例),比较两组无创血流动力学心功能指标,B型尿钠肽(BNP)、左室射血分数(LVEF)值,分析冠状动脉狭窄程度与心功能的关系.结果 疾病组室缩波波幅(C)、心搏出量(SV)、心输出量(CO)、心脏指数(CI)、心缩力指数(HI) LVEF均较对照组减低,差异有统计学意义(P＜0.05),收缩功能指数(Q-C/B-X) BNP较对照组增大,差异有统计学意义(P＜0.05);Gensini积分高分组BNP、LVEF较对照组及低分组差异均有统计学意义(P＜0.05).Gensini积分与各变量间Pearson相关性分析结果显示:Gensini积分与C、SV、CO、CI、HI、LVEF呈显著负相关(r=-0.523、-0.594、-0.540、-0.541、-0.533、-0.511,P＜0.01);与Q-B/B-X、BNP呈显著正相关(r=0.475、0.463,P＜0.01).结论 冠状动脉病变程度与心功能呈负相关,并且病变程度越重心功能越差.

Clinical study on the relationship between coronary artery lesion and cardiac function in patients with coronary heart disease

Objective To investigate the relationship between coronary artery lesion and cardiac function in coronary atherosclerotic heart disease (CHD) patients.Methods Ninty cases of patients with CHD who were hospitalized for chest pain in Air Force PLA General Hospital and scheduled for coronary angiography were selected.Noninvasive hemodynamie testing was performed before coronary angiography.According to the results of coronary angiography,74 patients with coronary artery stenosis were selected as disease group,persons with an additional angiography showed no coronary artery stenosis and excluded from other systemic diseases in physical examination center(30 cases) were chosed as control group.According to the results of coronary angiography,the Gensini score system was used to quantify the degree of coronary artery disease,the patients were divided into two groups according to the score.:high score group (Gensini score＞ 20 points,40 cases) and low score group (Gensini score≤20).And the relationship between coronary artery stenosis and cardiac function was analyzed by comparing the two groups of noninvasive hemodynamics cardiac function indexes,BNP and LVEF values.Results The levels of C,SV,CO,CI,HI and LVEF in the disease group were significantly lower than those in the control group (P＜0.05),Q-B/B-X was significantly higher than that in the control group (P＜0.05);There were statistically significant of BNP and LVEF between Gensini high score and low score group (P＜0.05).The Pearson correlation analysis showed there was significantly negatively correlated between Gensini score and C,SV,CO,CI,HI,LVEF,and significantly positively correlated btween Gensini score and Q-B/B-X,BNP.Conclusion The degree of coronary artery lesion was negatively correlated with cardiac function,and the worse the disease,the worse the heart function.