冠状动脉侧支血管评价心功能指数和心肌梗死面积的价值

The Value of Coronary Artery Collateral Vessels for Evaluating Cardiac Function Index and Myocardiol Infarct Size

为了探讨冠状动脉侧支血管能否对冠状动脉粥样硬化性心脏病患者预后和治疗提供线索，本文将68例冠状动脉闭塞患者分为侧支血管发展良好组和侧支血管发展不良组，比较两组间的静息心电图ST－T改变、运动负荷试验、心功能指标和心肌梗死面积。结果发现，与侧支血管发展不良组相比，侧支血管发展良好组心电图ST－T改变明显减少，QRS波积分和室壁异常运动积分明显降低，射血分数和心脏指数明显增高，左心室舒张期末压明显减小（P均＜0．01），两组间运动负荷试验阳性率无明显差异（P＞0．05），但侧支血管发展良好组中有4例未发生心肌梗死，其中3例运动负荷试验为阴性。结果提示，冠状动脉造影时观察侧支血管对冠状动脉粥样硬化性心脏病患者预后的预测和治疗的指导提供有价值的线索。

Aim To explore the providing leads of coronary artery collateral vessels in patients with coronary atherosclerotic heart disease on predicting prognosis and guiding treatment.Methods 68 patients with total occlusion of coro-nary arteries through coronary arteriograph were divid-ed into good development of collateral vessels group and poor development of collateral vessels group.Compared their ECG ST-T changes,motion stress testing.QRS scores,ventricular wall motion scores,ejection fraction,left ventricular end diastolic pressure and cardiac index between the two groups.Results Compared with the poor development of collateral vessels group,in the good development of collateral vessels group the ECG ST-T changes and left ventricular end diastolic pressure were obvious less(P <0.01),QRS scores and ventricular wall motion scores were lower(P<0.01),ejection fraction and cardiac index were higher(P<0.01),their positive rate of motion stress testing was not significant differ-ence(P<0.05).myocardium has not infarcted in 4patients of the good development of collateral vessels group,treadmill stress testing was negative in three of four cases.Conclusion Observing collateral vessels during coronary arteriograph can provide valuable leads in pa-tients with coronary atherosclerotic heart disease on predicting prognosis and guiding treatment.