临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
8期
647-650
,共4页
王微%孟亮%田志鹏%赵鑫
王微%孟亮%田誌鵬%趙鑫
왕미%맹량%전지붕%조흠
PCI%侧支循环%心功能%前降支
PCI%側支循環%心功能%前降支
PCI%측지순배%심공능%전강지
PCI%Collateral circulation%Cardiac function%Anterior descending
目的:探讨侧支循环对前降支单支病变冠心病经皮冠脉介入术( PCI)手术患者心脏功能的影响。方法回顾性分析2012年1月至2014年6月期间收治的284例前降支单支病变且行PCI手术的冠心病患者,根据冠脉造影结果分为无侧支循环组(A组,Rentrop0级,n=150)及存在侧支循环组(B组,Rentrop1、2、3级,n=134),根据侧支循环的来源将134例患者分为同侧组(B1组,n=20)、对侧组(B2组,n=91)、同侧﹢对侧组(B3组,n=23)。比较各组的术后即刻、术后1个月、3个月、6个月的左室舒张末内径( LVEDD)、左室收缩末内径( LVEDS)、左室射血分数( LVEF)、舒张早期二尖瓣最大流速与心房收缩期二尖瓣最大流速的比值( E/A),以及血浆脑钠肽( BNP)的水平。结果术后全部患者的心功能均有所改善,但B组的LVEDD、LVESD、BNP显著低于A组( P ﹤0.05),LVEF与E/A显著高于A组( P﹤0.05)。在B组内,B3组术后的心功能最佳,其次是B2组,B1组的术后心功能最差。结论侧支循环可以显著改善前降支单支病变冠心病患者PCI手术后的心功能,且同侧﹢对侧侧支循环的患者的心功能恢复程度最佳,其次是对侧侧支循环,同侧侧支循环最差。
目的:探討側支循環對前降支單支病變冠心病經皮冠脈介入術( PCI)手術患者心髒功能的影響。方法迴顧性分析2012年1月至2014年6月期間收治的284例前降支單支病變且行PCI手術的冠心病患者,根據冠脈造影結果分為無側支循環組(A組,Rentrop0級,n=150)及存在側支循環組(B組,Rentrop1、2、3級,n=134),根據側支循環的來源將134例患者分為同側組(B1組,n=20)、對側組(B2組,n=91)、同側﹢對側組(B3組,n=23)。比較各組的術後即刻、術後1箇月、3箇月、6箇月的左室舒張末內徑( LVEDD)、左室收縮末內徑( LVEDS)、左室射血分數( LVEF)、舒張早期二尖瓣最大流速與心房收縮期二尖瓣最大流速的比值( E/A),以及血漿腦鈉肽( BNP)的水平。結果術後全部患者的心功能均有所改善,但B組的LVEDD、LVESD、BNP顯著低于A組( P ﹤0.05),LVEF與E/A顯著高于A組( P﹤0.05)。在B組內,B3組術後的心功能最佳,其次是B2組,B1組的術後心功能最差。結論側支循環可以顯著改善前降支單支病變冠心病患者PCI手術後的心功能,且同側﹢對側側支循環的患者的心功能恢複程度最佳,其次是對側側支循環,同側側支循環最差。
목적:탐토측지순배대전강지단지병변관심병경피관맥개입술( PCI)수술환자심장공능적영향。방법회고성분석2012년1월지2014년6월기간수치적284례전강지단지병변차행PCI수술적관심병환자,근거관맥조영결과분위무측지순배조(A조,Rentrop0급,n=150)급존재측지순배조(B조,Rentrop1、2、3급,n=134),근거측지순배적래원장134례환자분위동측조(B1조,n=20)、대측조(B2조,n=91)、동측﹢대측조(B3조,n=23)。비교각조적술후즉각、술후1개월、3개월、6개월적좌실서장말내경( LVEDD)、좌실수축말내경( LVEDS)、좌실사혈분수( LVEF)、서장조기이첨판최대류속여심방수축기이첨판최대류속적비치( E/A),이급혈장뇌납태( BNP)적수평。결과술후전부환자적심공능균유소개선,단B조적LVEDD、LVESD、BNP현저저우A조( P ﹤0.05),LVEF여E/A현저고우A조( P﹤0.05)。재B조내,B3조술후적심공능최가,기차시B2조,B1조적술후심공능최차。결론측지순배가이현저개선전강지단지병변관심병환자PCI수술후적심공능,차동측﹢대측측지순배적환자적심공능회복정도최가,기차시대측측지순배,동측측지순배최차。
Objective To explore the effect of establishment of collateral circulation on cardiac function in patients receiving percutaneous coronary intervention( PCI)for treatment of lesions in single left anterior descending artery. Methods The clinical data of 284 patients receiving PCI for treatment of lesions in single left anterior descending artery during January 2012 to June 2014 were retrospectively analyzed. These patients were divided into without collateral circulation group(group A,Rentrop grade 0,n=150)and collateral circulation group(group B,Rentrop grades 1,2 and 3,n=134)according to the results of coronary angiography. The above-mentioned 134 patients were further divided into insilat-eral group(group B1,n=20),contralateral group(group B2,n=91)and insilateral﹢contralateral group(group B3,n=23)according to the source of collateral circulation. LVEDD,LVEDS,LVEF,E/A and plasma level of BNP were compared among all these groups immediately,1 month,3 and 6 months after operation. Results Postoperative cardiac function in all patients had been improved,but LVEDD,LVESD and plas-ma level of BNP in patients of group B were significantly lower than those of patients in group A( P ﹤0. 05),while LVEF and E/A were signifi-cantly higher than those of patients in group A( P ﹤0. 05). Among patients in group B,postoperative cardiac function of patients in group B3 was the best,followed by patients in group B2,and that of patients in group B1 was the worst. Conclusion The establishment of collateral circulation can significantly improve the cardiac function of patients receiving PC intervention in a single left anterior descending artery. Postoperative cardiac function of patients with insilateral﹢contralateral collateral circulation is the best,followed by cases with contralateral collateral circulation. The postoperative cardiac function in patients with insilateral collateral circulation is the worst.