冠心病左室结构与功能相关关系的临床分析

目的　探讨冠心病不同阶段的检查结果与心脏结构、功能关系。方法　通过对 2 2 6例患者临床资料的分析 ,对比心绞痛和心肌梗死对左室结构和功能的影响。结果　主动脉内径、左房内径、左室舒张期内径、舒张末期容积、收缩末期容积、每搏输出量、心输出量、平均室壁厚度和左室心肌质量等参数冠心病各组较正常组有增加的趋势而射血分数、左室短轴缩短率降低 ,收缩功能参数与心室结构变化有关 ;舒张早期血流的峰值流速随心肌损害加重而减低 ,舒张功能参数与冠状动脉严重程度密切相关。冠心病冠状动脉造影阴性损害也同样大。结论　冠心病人出现心室重构 ,收缩、舒张功能逐渐恶化。因此 ,控制心室重构意义重大。

Clinical Correlation Analysis of Left Ventricular Structure and Function in Coronary Artery Disease

Objective To study the left ventricular structure and function and their relationship of clinical data in the patients with coronary artery disease. Methods All of 226 patients were divided into five groups, and underwent electrocardiogram, Holter, coronary angiography and echocardiology to investigate the coronary pathological changes and the influence on left ventricular structure and function. Results The left ventricular structure and function data deteriorated with the coronary pathological changes becoming more serious, compared with the normal control group. Aortic diameter, left atrial diameter, end diastolic diameter of left ventricle,left ventricular mass,end diastolic volume of left ventricle and end systolic volume of left ventricle increased significantly; meanwhile,ejection fraction and fractional shortening of the minor semi axis decreased. The left ventricular systolic function parameters were related to left ventricular structure. The early peak flow velocity became lower when the ischemic myocardial lesions were getting worse. Statistic results showed a good correlation between the left ventricular diastolic function parameters and the location of coronary artery lesion. The patients with acute myocardial infarction whose coronary lesion were less than 50% had similar cardiac function compared with patients had severe coronary lesion. Conclusion The left ventricular diastolic and systolic function of the patients with coronary artery disease deteriorated during the myocardial remodeling. It is suggested that intervention during myocardial remodeling is effective in the treatment of coronary artery disease.