左室射血分数与冠心病患者粥样斑块的关系

目的：探讨左室射血分数（LVEF）水平在冠心病患者中的变化特点及其与粥样斑块特征的关系。方法：对拟诊冠心病的103例患者,均行冠状动脉造影（CAG）检查,均行左室造影（LVA）。CAG结果阴性者纳为对照组（30例）,其余包括稳定型心绞痛（SA）组（15例）、不稳定型心绞痛（UA）组（37例）和急性心肌梗死（AMI）组（21例）。对其中的7例SA患者、27例UA患者行血管内超声（IVUS）检查。观察冠心病患者LVEF水平的变化特点。结果：AMI组LVEF水平低于其他3组（P〈0.01）;UA组与SA组差异无统计学意义（P〉0.05）,但低于对照组（P〈0.01）;SA组与对照组差异无统计学意义（P〉0.05）。冠脉中重度狭窄组LVEF水平低于轻度狭窄组（P〈0.01）。结论：LVEF水平可反映冠脉病变狭窄程度。但在SA、UA患者中,LVEF水平不能反映斑块稳定程度。

Relation between Left Ventricular Ejection Fraction and Features of Atherosclerotic Plaques in Patients with Coronary Artery Disease

Objective: To investigate the clinical significance of left ventricular ejection fraction (LVEF) and the relationship between LVEF level and the features of atherosclerotic plaques in patients with coronary artery disease (CAD). Methods: A clinical research was performed in 103 patients diagnosed as CAD. Research objects were divided into four groups: 30 patients in the control group with negative result in coronary angiography (CAG), 15 patients with stable angina (SA) group, 37 patients with unstable angina (UA) and 21 patients with acute myocardial infarction (AMI) group. All of the objects underwent CAG and left ventricular angiography (LVA). At the same time 7 patients with SA and 27 patients with UA underwent intravascular ultrasound (IVUS) to analyze the coronary lesions. Results: The LVEF level decreased significantly in AMI group compared to those of the other three groups (P< 0.01). The LVEF level decreased significantly in UA group compared to that of control group (P < 0.01). However, there was no significant difference in LVEF level between UA and SA groups (P > 0.05). Also there was no significant difference in LVEF level between SA and control groups (P > 0.05). In the mean time, the level of LVEF significantly decreased in medium-severe stenosis group compared to that of slight stenosis group (P< 0.01). There was no significant difference between stable plaque group and unstable plaque group (P > 0.05). Conclusion: The level of LVEF might reflect the level of stenosis of coronary artery segment. But for patients with SA and UA, the level of LVEF has no obvious relation with the vulnerability of atherosclerotic plaques.