冠心病左室射血功能研究

Study on left ventricular eject function of coronary heart disease

目的：研究冠心病左室射血功能。方法：以经胸壁与经食道二维超声彩色多普勒技术研究急性心肌梗死、心绞痛心肌缺血及正常人３ 组共 １００ 例的左室射血功能。结果：急性心肌梗死第４ 周左室射血功能多有改变，其主要表现并非每搏量及心输出量的降低，而是射血分数的下降及完成射血的作功方式的变化，即由正常时的室中部环向收缩及轴向收缩为主改变为以左室底部二尖瓣下水平环向收缩为主。结论：这种改变可能产生左室内瞬间紊乱血流或逆向血流，形成不同层面的瞬间压力阶差及室壁不同区域的张力阶差。以此使左室在空间上由正常的椭圆体形趋向于变为球体形，即促使左室重构的发生与发展。

Objective:To evaluate the left ventricular (LV) eject function of patient with coronary artery disease.Method:The LV eject function was studied by two dimentional echocardiography with through thorax and through esophagus methods in 3 groups (100 cases) of acute myo cardial infarction(AMI)angina pectoris and normal individuals. Result:The present result showed that the LV eject function was changed in most cases with AMI.The main changes were not appeared in the stroke volume and the cardiac output but the LV performance.In the normal,when LV constricted the papillar level ring constriction should be more significant than the mitral level ring constriction.However,it was reversed in AMI.Conclusion:This change would let blood flow become turbulent or reverse in LV cavity.The instantaneous pressure difference among the different layers in LV and wall would appear.The change of eject function would let LV lose its normal cone spatial geometry and became toward a global one and would accelerate LV remodelling.