摘要
目的探讨冠状动脉慢性完全性闭塞(chronic total occlusion, CTO)患者经皮冠状动脉介入手术(percutaneous coronary intervention, PCI)治疗前、后左心室功能及心脏重构相关指标的变化及意义。方法行PCI治疗的120例冠状动脉CTO患者为CTO组,其中单支冠状动脉CTO病变78例(单支CTO组),≥2支冠状动脉CTO病变42例(≥2支CTO组),同期40例体检健康者为对照组。采用超声心动图检测对照组及CTO组患者PCI治疗前、后左心房内径(left atrial diameter, LAD)、左心室内径(left ventricular diameter, LVD)、左室射血分数(left ventricular ejection fraction, LVEF)、左心室舒张末期容积(left ventricular end-diastolic volume, LVEDV)、左心室收缩末期容积(left ventricular end-systolic volume, LVESV)、左心室壁厚度(left ventricular wall thickness, LVPW)、室间隔厚度(interventricular septal thickness, IVS),比较CTO组与对照组、单支CTO组与≥2支CTO组以及CTO组患者PCI治疗前、后左心功能和心脏重构指标的变化。结果 CTO组患者LAD[(37.3±3.8)mm]、LVD[(51.8±6.4)mm]、LVEDV[(151.8±38.9)mL]、LVESV[(59.5±16.3)mL]、LVPW[(13.4±1.7)mm]、IVS[(13.5±1.9)mm]均明显高于对照组[(32.0±3.1)mm、(40.9±5.0)mm、(110.7±21.8)mL、(47.8±13.0)mL、(9.8±1.5)mm、(10.0±1.3)mm](P<0.05),LVEF[(56.3±5.0)%]低于对照组[(63.2±4.7)%](P<0.05);单支CTO组患者LAD[(36.9±3.7)mm]、LVD[(50.7±4.9)mm]、LVEDV[(144.2±34.0)mL]、LVESV[(55.6±14.9)mL]、LVPW[(12.6±1.1)mm]、IVS[(13.0±1.5)mm]均低于≥2支CTO组[(38.2±3.4)mm、(54.2±5.6)mm、(163.8±31.5)mL、(68.5±13.4)mL、(14.2±1.4)mm、(14.2±1.6)mm](P<0.05),LVEF[(59.4±4.7)%]高于≥2支CTO组[(53.2±4.8)%](P<0.05);随访12个月,CTO组患者LAD[(35.0±3.4)mm]、LVD[(47.8±5.9)mm]、LVEDV[(138.5±20.0)mL]、LVESV[(50.8±14.2)mL]、LVPW[(12.6±1.5)mm]、IVS[(12.8±1.1)mm]较PCI治疗前明显降低(P<0.05),LVEF[(60.2±4.8)%]较治疗前升高(P<0.05)。结论冠状动脉CTO患者心功能受损严重、心脏重构形成,PC
Objective To explore the changes and significances of left ventricular function and cardiac remodeling related indicators after percutaneous coronary intervention(PCI) in patients with coronary chronic total occlusion(CTO). Methods Totally 120 patients with coronary CTO undergoing PCI(CTO group) included 78 patients with single branch of coronary CTO(single CTO group) and 42 patients with ≥ 2 branches of coronary CTO(≥ 2 CTO group), and another 40 healthy volunteers were as controls(control group). Echocardiography was used to measure left atrial diameter(LAD), left ventricular diameter(LVD), left ventricular ejection fraction(LVEF), left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV), left ventricular wall thickness(LVPW),interventricular septal thickness(IVS)before and after PCI in CTO group and control group.The changes of left ventricular function and cardiac remodeling indexes were compared between CTO group and control group,single CTO group and≥2 CTO group,and before and after PCI in CTO patients.Results In CTO group,LAD((37.3±3.8)mm),LVD((51.8±6.4)mm),LVEDV((151.8±38.9)mL),LVESV((59.5±16.3)mL),LVPW((13.4±1.7)mm)and IVS((13.5±1.9)mm)were significantly higher than those in control group((32.0±3.1)mm,(40.9±5.0)mm,(110.7±21.8)mL,(47.8±13.0)mL,(9.8±1.5)mm,(10.0±1.3)mm)(P<0.05),and LVEF((56.3±5.0)%)was significantly lower than that in control group((63.2±4.7)%)(P<0.05).In single CTO group,LAD((36.9±3.7)mm),LVD((50.7±4.9)mm),LVEDV((144.2±34.0)mL),LVESV((55.6±14.9)mL),LVPW((12.6±1.1)mm)and IVS((13.0±1.5)mm)were significantly lower than those in ≥2 CTO group((38.2±3.4)mm,(54.2±5.6)mm,(163.8±31.5)mL,(68.5±13.4)mL,(14.2±1.4)mm,(14.2±1.6)mm)(P<0.05),and LVEF((59.4±4.7)%)was significantly higher than that in ≥2 CTO group((53.2±4.8)%)(P<0.05).In CTO group,LAD((35.0±3.4)mm),LVD((47.8±5.9)mm)LVEDV((138.5±20.0)mL),LVESV((50.8±14.2)mL),LVPW((12.6±1.5)mm)and IVS((12.8±1.1)mm)after 12-month follow-up were significantly lower than those before P
作者
丁丹
王雪臣
李庆海
DING Dan;WANG Xuechen;LI Qinghai(Department of Internal Medicine,the Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450008,China)
出处
《中华实用诊断与治疗杂志》
2019年第4期343-346,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省2016科技发展计划(162300410097)
关键词
冠状动脉慢性完全性闭塞
左心室功能
心脏重构
经皮冠状动脉介入手术
coronary chronic total occlusion
left ventricular function
cardiac remodeling
percutaneous coronary in tervention
