中国医药
中國醫藥
중국의약
China Medicine
2015年
12期
1733-1737
,共5页
付晓葆%王宏宇%连艳凯%吴永全
付曉葆%王宏宇%連豔凱%吳永全
부효보%왕굉우%련염개%오영전
冠状动脉疾病%左心室舒张功能%颈-股脉搏波速度
冠狀動脈疾病%左心室舒張功能%頸-股脈搏波速度
관상동맥질병%좌심실서장공능%경-고맥박파속도
Coronary heart disease%Left ventricular diastolic function%Carotid-femoral pulse wave velocity
目的 分析冠状动脉粥样硬化性心脏病(冠心病)患者左心室舒张功能与冠状动脉狭窄程度和大动脉弹性大动脉弹性的相关性.方法 纳入2009年6月至2010年3月行冠状动脉造影和左心室造影的疑似冠心病患者81例,根据冠状动脉造影结果分为冠心病组和对照组.检测颈-股脉搏波速度(cfPWV)以评价大动脉弹性,采用有创心导管术检测左心室舒张末期压力(LVEDP)反映左心室舒张功能,对冠心病组患者通过计算Gensini积分评估冠状动脉病变程度.比较2组间一般基线资料、超声心动图指标、cfPWV及LVEDP差异;分析冠心病组患者LVEDP与心血管危险因素、超声心动图指标、Gensini积分及cfPWV的相关性.结果 冠心病组患者56例、对照组患者25例,冠心病组患高血压和糖尿病比例、左心室后壁厚度(LVPWT)、左心室质量指数(LVMl)、左心室射血分数(LVEF)、LVEDP和cfPWV与对照组比较差异均有统计学意义[73.2％ (41/56)比48.0％ (12/25)、57.1％(32/56)比16.0％ (4/25)、(0.99±0.12)cm比(0.94±0.10)cm、(125±29)g/m2比(108±22)g/m2、(66±7)％比(69±6)％、(21±10) mmHg比(16±5) mmHg(1 mmHg =0.133 kPa)、(8.3±2.l)m/s比(7.1±2.0)m/s](均P＜0.05);采用多元Logistic回归排除混杂因素后,2组间LVEDP差异有统计学意义(P＜0.05或P＜0.01),cfPWV差异无统计学意义(P＞0.05).Pearson相关分析显示LVEDP与冠状动脉Gensini积分、中心动脉收缩压、室间隔厚度(IVST)之间呈正相关(r=0.336,P=0.001;r =0.381,P=0.004;r=0.266,P=0.009),与cfPWV无相关性(r=-0.154,P=0.258);对Gensini积分、中心动脉收缩压、IVST与LVEDP相关性行Logistic多元逐步回归,显示Gensini积分和中心动脉收缩压与LVEDP独立相关(P＜0.05).结论 冠心病患者左心室舒张功能与冠状动脉狭窄程度呈正相关,与大动脉弹性无相关性.
目的 分析冠狀動脈粥樣硬化性心髒病(冠心病)患者左心室舒張功能與冠狀動脈狹窄程度和大動脈彈性大動脈彈性的相關性.方法 納入2009年6月至2010年3月行冠狀動脈造影和左心室造影的疑似冠心病患者81例,根據冠狀動脈造影結果分為冠心病組和對照組.檢測頸-股脈搏波速度(cfPWV)以評價大動脈彈性,採用有創心導管術檢測左心室舒張末期壓力(LVEDP)反映左心室舒張功能,對冠心病組患者通過計算Gensini積分評估冠狀動脈病變程度.比較2組間一般基線資料、超聲心動圖指標、cfPWV及LVEDP差異;分析冠心病組患者LVEDP與心血管危險因素、超聲心動圖指標、Gensini積分及cfPWV的相關性.結果 冠心病組患者56例、對照組患者25例,冠心病組患高血壓和糖尿病比例、左心室後壁厚度(LVPWT)、左心室質量指數(LVMl)、左心室射血分數(LVEF)、LVEDP和cfPWV與對照組比較差異均有統計學意義[73.2％ (41/56)比48.0％ (12/25)、57.1％(32/56)比16.0％ (4/25)、(0.99±0.12)cm比(0.94±0.10)cm、(125±29)g/m2比(108±22)g/m2、(66±7)％比(69±6)％、(21±10) mmHg比(16±5) mmHg(1 mmHg =0.133 kPa)、(8.3±2.l)m/s比(7.1±2.0)m/s](均P＜0.05);採用多元Logistic迴歸排除混雜因素後,2組間LVEDP差異有統計學意義(P＜0.05或P＜0.01),cfPWV差異無統計學意義(P＞0.05).Pearson相關分析顯示LVEDP與冠狀動脈Gensini積分、中心動脈收縮壓、室間隔厚度(IVST)之間呈正相關(r=0.336,P=0.001;r =0.381,P=0.004;r=0.266,P=0.009),與cfPWV無相關性(r=-0.154,P=0.258);對Gensini積分、中心動脈收縮壓、IVST與LVEDP相關性行Logistic多元逐步迴歸,顯示Gensini積分和中心動脈收縮壓與LVEDP獨立相關(P＜0.05).結論 冠心病患者左心室舒張功能與冠狀動脈狹窄程度呈正相關,與大動脈彈性無相關性.
목적 분석관상동맥죽양경화성심장병(관심병)환자좌심실서장공능여관상동맥협착정도화대동맥탄성대동맥탄성적상관성.방법 납입2009년6월지2010년3월행관상동맥조영화좌심실조영적의사관심병환자81례,근거관상동맥조영결과분위관심병조화대조조.검측경-고맥박파속도(cfPWV)이평개대동맥탄성,채용유창심도관술검측좌심실서장말기압력(LVEDP)반영좌심실서장공능,대관심병조환자통과계산Gensini적분평고관상동맥병변정도.비교2조간일반기선자료、초성심동도지표、cfPWV급LVEDP차이;분석관심병조환자LVEDP여심혈관위험인소、초성심동도지표、Gensini적분급cfPWV적상관성.결과 관심병조환자56례、대조조환자25례,관심병조환고혈압화당뇨병비례、좌심실후벽후도(LVPWT)、좌심실질량지수(LVMl)、좌심실사혈분수(LVEF)、LVEDP화cfPWV여대조조비교차이균유통계학의의[73.2％ (41/56)비48.0％ (12/25)、57.1％(32/56)비16.0％ (4/25)、(0.99±0.12)cm비(0.94±0.10)cm、(125±29)g/m2비(108±22)g/m2、(66±7)％비(69±6)％、(21±10) mmHg비(16±5) mmHg(1 mmHg =0.133 kPa)、(8.3±2.l)m/s비(7.1±2.0)m/s](균P＜0.05);채용다원Logistic회귀배제혼잡인소후,2조간LVEDP차이유통계학의의(P＜0.05혹P＜0.01),cfPWV차이무통계학의의(P＞0.05).Pearson상관분석현시LVEDP여관상동맥Gensini적분、중심동맥수축압、실간격후도(IVST)지간정정상관(r=0.336,P=0.001;r =0.381,P=0.004;r=0.266,P=0.009),여cfPWV무상관성(r=-0.154,P=0.258);대Gensini적분、중심동맥수축압、IVST여LVEDP상관성행Logistic다원축보회귀,현시Gensini적분화중심동맥수축압여LVEDP독립상관(P＜0.05).결론 관심병환자좌심실서장공능여관상동맥협착정도정정상관,여대동맥탄성무상관성.
Objective To investigate the correlation among left ventricular diastolic function, coronary stenosis degree and arterial elasticity in patients with coronary heart disease (CHD).Methods Totally 81 patients with suspected coronary heart disease who underwent coronary angiography and left ventriculography were enrolled and divided into CHD group and control group.The carotid-femoral pulse wave velocity (cfPWV)was measured to evaluate the arterial elasticity;the left ventricular end diastolic pressure (LVEDP) was determined by invasive cardiac catheterization, and the coronary stenosis degree in CHD group was assessed by Gensini score.The correlations among LVEDP, cardiovascular risk factors, echocardiography parameters, Gensini scores and cfPWV were analyzed.Results There were 56 cases in CHD group and 25 cases in control group.In CHD group, the proportion of hypertension and diabetes, left ventricular posterior wall thickness (LVPWT) , left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), LVEDP and cfPWV were all significantly different with those in control group [73.2％ (41/56) vs 48.0％ (12/25) , 57.1％ (32/56) vs 16.0％(4/25), (0.99±0.12) cm vs (0.94±0.10) cm, (125±29) g/m2 vs (108±22) g/m2, (66±7) ％ vs (69 ±6) ％, (21±10) mmHgvs (16±5) mmHg, (8.3 ±2.1) m/s vs (7.1 ±2.0) m/s] (P＜0.05 or P＜0.01);after removing the confounding factors by Logistic analysis, there was significant difference regarding LVEDP (P ＜ 0.05), while no difference regarding cfPWV (P ＞ 0.05) between the two groups.Pearson analysis showed that LVEDP was positively correlated with Gensini score, central aortic systolic blood pressure, and interventricular septum thickness (IVST) (r =0.336, P =0.001;r =0.381, P =0.004;r =0.266, P =0.009), but it was not correlated with cfPWV (r =-0.154, P =0.258).Multiple Logistic stepwise regression analysis showed that LVEDP was positively correlated with Gensini score and central aortic systolic blood pressure (P ＜ 0.05).Conclusion Impaired left ventricular diastolic function is positively correlated with coronary stenosis degree but it is not correlated with arterial elasticity in CHD patients.
