Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pectoris (UAP) and observe the relations between the heart function and severity ...Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pectoris (UAP) and observe the relations between the heart function and severity of coronary arterial disease. Methods 70 cases with UAP were enrolled including 25 patients with angina decubitus (AD), 23 patients with mixed angina (MA) , and 22 patients with accelerated effort angina (AEA). All patients underwent a series of examination such as UCG, ECT, hemodynamics and volume-loading test. The patients were divided into three groups in light of the results of the hemodynamic examination: ① diastolic dysfunction group ② systolic dysfunction group ③ normal heart function group. We assessed the basic heart function and cardiac reserve function of patients with different types of UAP and also observed the relations between coronary arteriography and heart function. Results ① Under basic conditions, patients with angina decubitus suffered from the systolic (36%) or diastolic dysfunction (48%). 43 percent of the patients with mixed angina had systolic dysfunction and other 43 percent of them had normal cardiac function. However, patients with accelerated effort angina (AEA) were characterized by diastolic dysfunction (31%) or normal heart function (60%). ② In hemodynamic examination, the pulmonary capillary wedge pressure of positive patients rose, at the same time cardiac index fell to the extreme instantaneously after loading in volume-loading test and then they restored to the basic level until 60 minutes. However, both PCWP and CI of the negative patients reach the peak momentarily after loading. They returned to the basic level within 30 minutes. ③ coronary arteriography show: there are 41% of patient with three-vessel disease, 50% with two-vessel disease, 9% single vessel disease and left main narrowing 22. 7% in AEA. There are separately 76%, 24%, 0% and 36% in AD; and 26.1% , 43.4% , 21.7% , 43.4% in MA. ④ Constituent ratio of the AEA and MA were separately compared with AD, AEA/AD: P < 0.05(P = 0.031); MA/AD: P < 0.01 (P = 0.000313). Conclusions Most of patients with the above three types of unstable angina pectoris suffered from the basic heart dysfunction and cardiac reserve dysfunction which might participate in the occurrence and development of unstable angina pectoris. In angiography, there are the most three-vessel diseases in AD that are, therefore, the most severe UAP.展开更多
目的 探讨曲美他嗪对不稳定型心绞痛（UAP）患者经皮冠状动脉介入治疗（PCI）术相关心肌损伤及术后左心室功能的影响。方法 入选2011年1月至2014年1月在高州市人民医院心内科拟行择期PCI术的UAP患者106例，采用随机数字表法分为两组：...目的 探讨曲美他嗪对不稳定型心绞痛（UAP）患者经皮冠状动脉介入治疗（PCI）术相关心肌损伤及术后左心室功能的影响。方法 入选2011年1月至2014年1月在高州市人民医院心内科拟行择期PCI术的UAP患者106例，采用随机数字表法分为两组：曲美他嗪组（n＝51）和对照组（n＝55）。曲美他嗪组在常规药物治疗的基础上，于PCI术前0.5～1.0h口服60 mg曲美他嗪（负荷剂量），PCI术后口服常规剂量曲美他嗪（20mg，3次/d）。分别测定PCI术前和术后16～18h患者血清肌钙蛋白I（cTnI）浓度，通过电话随访了两组患者PCI术后的相关情况。结果 PCI术后16～18h时，两组患者的cTnI水平均高于术前（P＜0.05），且两组比较差异有统计学意义（P＜0.05）。与对照组相比，曲美他嗪组患者术后cTnI水平＞0.10μg/L的患者比例较少（P＜0.05）。截至随访结束，曲美他嗪组患者左心室收缩末内径（LVESd）显著低于对照组[（31.00±4.33） vs （33.29±2.11）mm；P＜0.05]，左心室射血分数（LVEF）明显高于对照组[（65.65±3.94）% vs （62.29±3.06）%；P＜0.05]，两组患者主要心血管事件（MACE）发生率差异无统计学意义（7.8% vs 9.1%）。结论 PCI术前口服负荷剂量曲美他嗪可减少手术相关心肌损伤，术后长期服用可改善患者左心室功能。展开更多
文摘Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pectoris (UAP) and observe the relations between the heart function and severity of coronary arterial disease. Methods 70 cases with UAP were enrolled including 25 patients with angina decubitus (AD), 23 patients with mixed angina (MA) , and 22 patients with accelerated effort angina (AEA). All patients underwent a series of examination such as UCG, ECT, hemodynamics and volume-loading test. The patients were divided into three groups in light of the results of the hemodynamic examination: ① diastolic dysfunction group ② systolic dysfunction group ③ normal heart function group. We assessed the basic heart function and cardiac reserve function of patients with different types of UAP and also observed the relations between coronary arteriography and heart function. Results ① Under basic conditions, patients with angina decubitus suffered from the systolic (36%) or diastolic dysfunction (48%). 43 percent of the patients with mixed angina had systolic dysfunction and other 43 percent of them had normal cardiac function. However, patients with accelerated effort angina (AEA) were characterized by diastolic dysfunction (31%) or normal heart function (60%). ② In hemodynamic examination, the pulmonary capillary wedge pressure of positive patients rose, at the same time cardiac index fell to the extreme instantaneously after loading in volume-loading test and then they restored to the basic level until 60 minutes. However, both PCWP and CI of the negative patients reach the peak momentarily after loading. They returned to the basic level within 30 minutes. ③ coronary arteriography show: there are 41% of patient with three-vessel disease, 50% with two-vessel disease, 9% single vessel disease and left main narrowing 22. 7% in AEA. There are separately 76%, 24%, 0% and 36% in AD; and 26.1% , 43.4% , 21.7% , 43.4% in MA. ④ Constituent ratio of the AEA and MA were separately compared with AD, AEA/AD: P < 0.05(P = 0.031); MA/AD: P < 0.01 (P = 0.000313). Conclusions Most of patients with the above three types of unstable angina pectoris suffered from the basic heart dysfunction and cardiac reserve dysfunction which might participate in the occurrence and development of unstable angina pectoris. In angiography, there are the most three-vessel diseases in AD that are, therefore, the most severe UAP.
文摘目的 探讨曲美他嗪对不稳定型心绞痛（UAP）患者经皮冠状动脉介入治疗（PCI）术相关心肌损伤及术后左心室功能的影响。方法 入选2011年1月至2014年1月在高州市人民医院心内科拟行择期PCI术的UAP患者106例，采用随机数字表法分为两组：曲美他嗪组（n＝51）和对照组（n＝55）。曲美他嗪组在常规药物治疗的基础上，于PCI术前0.5～1.0h口服60 mg曲美他嗪（负荷剂量），PCI术后口服常规剂量曲美他嗪（20mg，3次/d）。分别测定PCI术前和术后16～18h患者血清肌钙蛋白I（cTnI）浓度，通过电话随访了两组患者PCI术后的相关情况。结果 PCI术后16～18h时，两组患者的cTnI水平均高于术前（P＜0.05），且两组比较差异有统计学意义（P＜0.05）。与对照组相比，曲美他嗪组患者术后cTnI水平＞0.10μg/L的患者比例较少（P＜0.05）。截至随访结束，曲美他嗪组患者左心室收缩末内径（LVESd）显著低于对照组[（31.00±4.33） vs （33.29±2.11）mm；P＜0.05]，左心室射血分数（LVEF）明显高于对照组[（65.65±3.94）% vs （62.29±3.06）%；P＜0.05]，两组患者主要心血管事件（MACE）发生率差异无统计学意义（7.8% vs 9.1%）。结论 PCI术前口服负荷剂量曲美他嗪可减少手术相关心肌损伤，术后长期服用可改善患者左心室功能。
