非心肌梗死患者冠状动脉狭窄程度与左心室射血分数的相关性研究

Correlation between Coronary Artery Stenosis Severity and Left Ventricular Ejection Fraction in Patients without Myocardial Infarction

目的探讨非心肌梗死患者冠状动脉狭窄程度与左心室射血分数（LVEF）的相关性.方法回顾性分析261例同期进行冠状动脉造影和超声心动描记术检查患者,根据冠状动脉狭窄程度分为对照组（A组,冠状动脉造影狭窄〈50%,46例）和冠心病组（冠状动脉狭窄≥50%,215例）.冠心病组以Gensini积分法进一步分为B组（Gensini积分≤10,78例）、C组（1040,42例）,分析4组间冠状动脉狭窄程度与超声心动描记术检查结果的相关性.结果（1）B、C、D组LVEF均小于A组（t=2.52、2.87、4.11,均P〈0.05）,D组小于B、C组（t=2.36、2.63,均P〈0.05）.（2）冠心病组及D组Gensini积分与LVEF呈负相关（r=-0.21和-0.36,均P〈0.05）.（3）LVEF〉60%的冠心病患者中两支或三支冠状动脉狭窄均≥90%者占9%,低于LVEF≤60%者（18%）,差异有统计学意义（字2=3.91,P〈0.05）.结论未曾发生心肌梗死的冠状动脉中重度狭窄患者可出现LVEF的不同程度下降,冠状动脉病变严重程度与LVEF之间呈低度负相关.

Objective To investigate the correlation between coronary stenosis severity and left ventricular ejection fraction （LVEF） in patients without myocardial infarction. Methods Coronary angiography and echocardiography performed during the same period were analyzed retrospectively in 261 cases. They were divided into group A （coronary stenosis〈50%, n=46） and coronary artery disease （CAD） group （coronary stenosis≥50%, n=215） based on coronary angiography. According to Gensini score （GSS）, CAD group was further divided into group B （GSS≤10, n=78） , group C （1040, n=42）. The correlation between coronary stenosis severity and LVEF was analyzed. Results （1）The LVEF was significantly lower in group B, C and D than in group A（t=2.52、2.87、4.11, P〈0.05）, and lower in group D than in group B and C（t=2.36、2.63, P〈0.05）. （2）There was a mild but significant negative correlation between LVEF and GGS in CAD group （r=-0.21, P〈0.05） and in group D （r=-0.36, P〈0.05）. （3）Patients with two- or three-vessel stenosis≥90%accounted for 9%in those with LVEF〉60%and 18%in those with LVEF≤60%（X2=3.91, P〈0.05）. Conclusion LVEF may decrease more or less in patients with moderate to severe coronary stenosis but no myocardial infarction. There is mild negative correlation between coronary artery disease severity and LVEF.