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目的探讨冠脉病变程度与心功能的关系及意义。方法通过临床症状诊断、生化检查、超声检查等手段检测204例冠心病患者与59例正常对照组(D组)患者的心功能情况。并于入院后2～7d对冠心病患者进行冠脉造影,采用Gensini冠脉评分系统将冠心病患者分为冠脉轻度病变组(A组)(<20分)、冠脉重度病变组(B组)(20～40分)和冠脉极重度病变组(C组)(≥40分)。结果与对照组相比,A、B、C3组在临床症状诊断及脑钠肽(BNP)上的差异均有统计学意义(P<0.05)。在超声诊断上,冠心病患者先出现舒张功能不全,与对照组差异有统计学意义(P<0.05);但A、B、C组间在A峰、E峰、E/A比值3项指标改变上无差异(P>0.05),而在EF斜率、Dd指标上的差异有统计学意义(P<0.05);而收缩功能,除SV、MVCF外A组与对照组差异无统计学意义(P>0.05)外,B、C2组与对照组均有差异(P<0.05)。冠心病3组之间收缩功能比较,差异也有统计学意义(P<0.05)。结论冠脉病变愈严重,Gensini冠脉评分越高,则其心功能损失愈大。
Objective To investigate the relationship between coronary artery disease and cardiac function and its significance. Methods The cardiac function of 204 patients with coronary heart disease and 59 normal controls (group D) was detected by means of clinical symptoms, biochemical tests and ultrasonography. Coronary angiography was performed in patients with coronary heart disease 2 ~ 7 days after admission. Patients with coronary artery disease were divided into mild coronary lesion group (group A) (<20 points), severe coronary artery disease group (group C) B group) (20-40 points) and severe coronary artery disease group (C group) (≥40 points). Results Compared with the control group, the differences of clinical symptoms and BNP between A, B and C3 groups were statistically significant (P <0.05). In the diagnosis of ultrasound, diastolic dysfunction was observed in patients with coronary heart disease at first, and there was significant difference between the two groups (P <0.05). However, there were no significant differences between the three groups in A, B and C groups (P <0.05), but there was a significant difference in EF slope and Dd index (P <0.05). There was no significant difference in systolic function except A and SV between SV and MVCF P> 0.05), B, C2 group and control group were different (P <0.05). There was also a significant difference in the systolic function between the three groups (P <0.05). Conclusion The more severe the coronary artery disease, the higher the Gensini coronary score, the greater the loss of cardiac function.