金岩,王辉山,姜辉,陶登顺,于岩.高血压对非体外循环下冠状动脉搭桥术前后左心室舒张功能变化的影响[J].中国医学影像技术,2011,27(8):1568~1571
高血压对非体外循环下冠状动脉搭桥术前后左心室舒张功能变化的影响
Impact of hypertension on left ventricular diastolic function before and after off-pump coronary artery bypass graft operation
  
DOI:
中文关键词:  心室功能障碍,左  非体外循环冠状动脉旁路移植术  高血压
英文关键词:Ventricular dysfunction, left  Off-pump coronary artery bypass graft  Hypertension
基金项目:
作者单位E-mail
金岩 中国人民解放军沈阳军区总医院心外科,辽宁 沈阳 110016 jinyan4158@vip.sina.com 
王辉山 中国人民解放军沈阳军区总医院心外科,辽宁 沈阳 110016  
姜辉 中国人民解放军沈阳军区总医院心外科,辽宁 沈阳 110016  
陶登顺 中国人民解放军沈阳军区总医院心外科,辽宁 沈阳 110016  
于岩 中国人民解放军沈阳军区总医院心外科,辽宁 沈阳 110016  
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中文摘要:
       目的 探讨对伴有高血压的冠心病患者行非体外循环下冠状动脉搭桥术前后的左心室舒张功能变化特点。 方法 93例接受非体外循环下冠状动脉搭桥术的患者根据是否合并高血压病,分为高血压组(HP组,38例)和血压正常组(NBP组,55例),术前、术后分别采集过二尖瓣的舒张早期(E)和舒张晚期(A)峰速及二尖瓣侧壁瓣环的收缩期(Sm)、舒张早期(Em)和舒张晚期(Am)峰速。 结果 HP组术前室壁运动积分(WMI)及肺动脉收缩压低于NBP组(P<0.05);NBP组患者的术前E/A和E/Em值显著高于HP组(P<0.05),术后1个月E/Em值即可降至接近正常范围,而HP组患者的E/Em值术后3个月才接近正常;两组患者的左心室射血分数术前均降低,术后1个月恢复正常。HP组患者左心室舒张功能分级较集中于1级和2级,共33例(33/38,86.84%),而NBP组患者各级所占比重较分散,最多为3级,20例(20/55,36.36%),其次为2级,17例(17/55,30.91%)。 结论 NBP组患者的左心室舒张功能受损程度较HP组严重;合并高血压的患者左心室舒张功能恢复较慢,长期、稳定降压治疗是改善冠状动脉搭桥术预后的有效措施。
英文摘要:
      Objective To explore the characteristic left ventricular diastolic function of patients with coronary artery diseases and hypertension before and after off-pump coronary artery bypass graft operation (OPCAB). Methods Ninety-three patients with OPCAB were divided into hypertension group (HP group, n=38) and normal blood pressure group (NBP group, n=55). The peak early (E) and late (A) inflow peak velocity of transmitral and the systolic (Sm) and early diastolic (Em) and late diastolic (Am) peak velocities at lateral mitral annulus were recorded respectively before and after OPCAB. Results Preoperative wall motion integral (WMI) and pulmonary artery systolic pressure (PASP) were lower in HP group than in NBP group (P<0.05). E/A and E/Em in NBP group were higher than in HP group (P<0.05), and E/Em recovered normally postoperative 1 month in NBP group, but 3 months in HP group. Preoperative left ventricular ejection fraction (LVEF) was lower in two groups, and improved in postoperative 1 month. Thirty-three patients (33/38, 86.84%) with left ventricular diastolic dysfunction in HP group was 1 or 2 grade, but the proportion of grading in NBP group was more distract, 20 patients (20/55, 36.36%) in 3 grade, and 17 patients (17/55, 30.91%) in 2 grade. Conclusion Left ventricular diastolic dysfunction in NBP group is more severe and improved more quickly than in HP group. It is effective to improve the prognosis of OPCAB with standard hypertension treatment.
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