CAJ | 학술논문

目的：探讨应用血流储备分数（FFR）评价心肌缺血对左心室舒张功能的影响。 　　方法：纳入因胸痛拟诊断冠心病或确诊冠心病并冠状动脉（冠脉）造影显示左冠状动脉支配心肌区域的冠心病患者57例，即冠脉血管主支单处狭窄临界病变（狭窄范围50%~70%；直径＜2.5 mm定义为无效血管）。所有患者均行心肌FFR的测量。根据FFR值分为实验组（FFR＜0.80，27例）和对照组（FFR≥0.80，30例）。比较两组患者一般情况及影响左心室舒张功能的危险因素，同时比较两组患者的超声心动图评价指标如左心室舒张末期内径、左心房内径、左心室射血分数以及舒张早期二尖瓣血流频谱E峰与二尖瓣环e`峰的比值（E/e`）有无差异。 　　结果：实验组与对照组患者在性别、年龄、高血压、糖尿病、胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、随机血糖等方面差异均无统计学意义（P均>0.05）；实验组患者的左心室舒张末期内径、左心房内径、左心室充盈压的指标E/e`值大于对照组（P<0.05），实验组患者的左心室射血分数小于对照组（P<0.05），差异均有统计学意义。 　　结论：冠心病对早期舒张功能的影响取决于心肌功能性缺血。
목적：탐토응용혈류저비분수（FFR）평개심기결혈대좌심실서장공능적영향。 　　방법：납입인흉통의진단관심병혹학진관심병병관상동맥（관맥）조영현시좌관상동맥지배심기구역적관심병환자57례，즉관맥혈관주지단처협착림계병변（협착범위50%~70%；직경＜2.5 mm정의위무효혈관）。소유환자균행심기FFR적측량。근거FFR치분위실험조（FFR＜0.80，27례）화대조조（FFR≥0.80，30례）。비교량조환자일반정황급영향좌심실서장공능적위험인소，동시비교량조환자적초성심동도평개지표여좌심실서장말기내경、좌심방내경、좌심실사혈분수이급서장조기이첨판혈류빈보E봉여이첨판배e`봉적비치（E/e`）유무차이。 　　결과：실험조여대조조환자재성별、년령、고혈압、당뇨병、담고순、감유삼지、저밀도지단백담고순、고밀도지단백담고순、수궤혈당등방면차이균무통계학의의（P균>0.05）；실험조환자적좌심실서장말기내경、좌심방내경、좌심실충영압적지표E/e`치대우대조조（P<0.05），실험조환자적좌심실사혈분수소우대조조（P<0.05），차이균유통계학의의。 　　결론：관심병대조기서장공능적영향취결우심기공능성결혈。
Objective: To explore the relationship between myocardial ischemia and left ventricular diastolic function (LVDF) by fractional lfow reserve (FFR) evaluation in patients with coronary artery disease (CAD). Methods: A total of 57 patients with chest pain were studied, the diagnosis of CAD was confirmed by coronary angiography, which indicated 50%-70%of coronary stenosis. All patients received FFR examination and they were divided into 2 groups:Experimental group, the patients with FFR<0.80, n=27 and Control group, the patients with FFR≥0.80, n=30. The basic condition and risk factors affecting LVDF were compared between 2 groups. Echocardiography was conducted for evaluating left ventricular end-diastolic dimension (LVEDD), left atrial dimension (LAD), left ventricular ejection fraction (LVEF) and E/e ' value in both groups. Results: The patients’ gender, age, history of hypertension, diabetes, blood levels of cholesterol, TG, LDL-C, HDL-C and glucose were similar between 2 groups, P>0.05. Compared with Control group, the Experimental group had the increased LVEDD, LAD and E/e ' value and decreased LVEF, all P<0.05. Conclusion: The impact of CAD on early diastolic function depends on functional myocardial ischemia in relevant patients.