冠脉病变程度与心功能关系的探讨

Relationship between Severity of Coronary Artery Lesion and Cardiac Function

目的探讨冠脉病变程度与心功能的关系及意义。方法通过临床症状诊断、生化检查、超声检查等手段检测204例冠心病患者与59例正常对照组(D组)患者的心功能情况。并于入院后2～7d对冠心病患者进行冠脉造影,采用Gensini冠脉评分系统将冠心病患者分为冠脉轻度病变组(A组)(<20分)、冠脉重度病变组(B组)(20～40分)和冠脉极重度病变组(C组)(≥40分)。结果与对照组相比,A、B、C3组在临床症状诊断及脑钠肽(BNP)上的差异均有统计学意义(P<0.05)。在超声诊断上,冠心病患者先出现舒张功能不全,与对照组差异有统计学意义(P<0.05);但A、B、C组间在A峰、E峰、E/A比值3项指标改变上无差异(P>0.05),而在EF斜率、Dd指标上的差异有统计学意义(P<0.05);而收缩功能,除SV、MVCF外A组与对照组差异无统计学意义(P>0.05)外,B、C2组与对照组均有差异(P<0.05)。冠心病3组之间收缩功能比较,差异也有统计学意义(P<0.05)。结论冠脉病变愈严重,Gensini冠脉评分越高,则其心功能损失愈大。

[Objective]To investigate the relationship between severity of coronary artery lesion and heart function in patients with coronary heart disease （CHD）.[Methods]Totally 204 patients with CHD and 59 normal control patients （group D） were recruited to detect the cardiac function in this study,through clinic symptomatic diagnosis,biochemistry checking （BNP） and ultrasonography.Coronary angiography was performed on patients 2～7 days after admission.CHD group was divided into 3 groups by the Gensini scoring：gentle coronary artery lesions group （group A：score20）,severe coronary artery lesions group （group B：score between 20～ 40）,much severe coronary artery lesions group （group C：score≥40）.[Results]The differences between group A,B,C and control group were significant on the clinic symptomatic diagnosis,biochemistry checking （BNP levels） （P〈0.05）.On ultrasonography,diastolic dysfunction first appeared on CHD patients,and it was different from the control group （P〈0.05）.On the change of the peak A,peak E,E/A ratio,there was no significant difference among group A,B,C （P〉0.05）,but significant differences on the change of EF slop and Dd existed （P〈0.05）.Except for SV,MVCF,systolic function,there was no significant difference between the group A and the control group （P〉0.05）.There were significant differences between groups B,C and the control group （P〈0.05）,and the differences on systolic function were significant among group A,B,C（P〈0.05）.[Conclusion]The more severe the coronary lesion is,the higher Gensini coronary score is,then the worst the cardiac function is.