超声心动图评估不稳定型心绞痛合并高血压患者冠脉病变的价值

摘要/Abstract

摘要： 目的：探讨利用超声心动图评价不稳定型心绞痛（UAP）合并高血压患者冠脉病变的应用价值。方法：选取2017年12月至2018年8月我院行冠状动脉造影（CAG）、符合UAP合并高血压诊断标准的患者73例作为病例组，CAG确诊无冠脉病变的健康体检者40例作为对照组。利用超声心动图测量左室射血分数（LVEF）；在脉冲多普勒（PW）下测量二尖瓣舒张早期血流峰值速度（E)、舒张晚期血流峰值速度(A)；组织多普勒（TDI）下测量二尖瓣环舒张早期峰(Ea)、舒张晚期峰(Aa)、收缩期峰(Sa)；测量并计算左室脉冲多普勒心肌做功指数（PW-Tei指数）及左室组织多普勒心肌做功指数（TDI-Tei指数）。比较两组LVEF、E/A、Ea/Aa、E/(Ea×Sa)、PW-Tei指数、TDI-Tei指数等超声心动图参数，并分析病例组超声心动图参数与代表冠脉病变狭窄程度的Gensini积分的相关性。结果：病例组LVEF[（56.51±8.59）%比（60.88±2.98）%]、E/A[(0.75±0.28)比（0.99±0.24）]、Ea/Aa[(0.74±0.21)比(1.19±0.34)]均小于对照组（P<0.05）；E/Ea[(10.9±3.23)比(7.78±2.04)]、E/(Ea×Sa) [(1.57±0.76)比(1.06±0.49)]、PW-Tei[(0.54±0.12)比(0.38±0.11)]、TDI-Tei[(0.56±0.11)比(0.38±0.11)]均高于对照组（P<0.05）。病例组中各变量与Gensini积分之间相关性分析结果显示：Gensini积分与收缩压、E/Ea、E/(Ea×Sa)、PW-Tei、TDI-Tei成显著正相关（r=0.385、0.372、0.455、0.608、0.692，P<0.01），与LVEF成显著负相关（r=-0.317，P<0.01）、与Ea/Aa成负相关（r=-0.240，P<0.05），但与舒张压、E/A无相关性（r=0.156、-0.112，P>0.05）。结论：超声心动图可以作为评价冠脉病变程度的工具，为判断UAP合并高血压患者的病情提供重要信息。

Abstract: Objective： To explore the value of echocardiography in the evaluation of coronary artery lesions in patients with unstable angina pectoris（UAP） complicated with hypertension. Methods： Patients who underwent coronary angiography in our hospital from December 2017 to August 2018 were selected，among whom 73 patients with UAP combined with hypertension were selected as the case group， and 40 healthy patients without coronary artery disease confirmed by coronary angiography as the control group. Left ventricular ejection fraction (LVEF) was measured by echocardiography. Peak blood flow velocity in early diastolic stage of mitral value(E) and peak blood flow velocity in late diastolic stage of mitral valve（A） were measured under pulsed wave doppler (PW). Mitral annulus diastolic early peak (Ea)， late diastolic peak (Aa)，and systolic peak (Sa)were measured under tissue doppler imaging(TDI).The left ventricular pulse doppler myocardial work index(PW-Tei index) and the left ventricular tissue doppler myocardial work index(TDI-Tei index) were measured and calculated.Echocardiographic parameters such as LVEF，E/A，Ea/Aa，E/(Ea×Sa)，PW-Tei index and TDI-Tei index of two groups were compared. The correlation between the echocardiographic parameters of the case group and the Gensini score representing the degree of coronary artery stenosis was analyzed. Results：The LVEF[(56.51±8.59)% vs (60.88±2.98)%]， E/A[(0.75±0.28) vs（0.99±0.24）]， Ea/Aa[(0.74±0.21) vs (1.19±0.34)] in the case group were smaller than the control group(P<0.05). E/Ea[(10.9±3.23) vs (7.78±2.04)]，E/(Ea×Sa) [(1.57±0.76) vs (1.06±0.49)]， PW-Tei[(0.54±0.12) vs (0.38±0.11)]， TDI-Tei[(0.56±0.11) vs (0.38±0.11)] in the case group were higher than the control group(P<0.05). The correlation analysis between the variables in the case group and the Gensini score showed that the Gensini score was significantly positively correlated with systolic blood pressure，E/Ea， E/(Ea×Sa)， PW-Tei and TDI-Tei (r=0.385， 0.372， 0.455， 0.608， 0.692， P<0.01)， and was significantly negatively correlated with LVEF (r=-0.317， P<0.01) and negatively correlated with Ea/Aa (r=-0.240， P<0.05)， but the Gensini score was not correlated with diastolic blood pressure and E/A (r=0.156， -0.112， P>0.05). Conclusion： Echocardiography can be used as a tool to evaluate the extent of coronary lesions， providing important information for judging the condition of patients with UAP complicated with hypertension.

时盼盼,王慧敏,戴红艳. 超声心动图评估不稳定型心绞痛合并高血压患者冠脉病变的价值[J]. .

Shi PanPan,Wang HuiMin and Dai HongYan. The Value of Echocardiography in Assessing Coronary Artery Lesions in Patients with Unstable Angina Pectoris Complicated with Hypertension[J]. .

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