钱菊英,葛均波,沈学东,DBaumgart,MHaude,RErbel,林佑善,陈灏珠

• 1:上海市心血管病研究所
• 2:上海市中山医院
• 3:上海市心血管病研究所
• 4:上海市中山医院

摘要(Abstract)：

目的　本研究旨在通过对有胸痛但冠状动脉造影正常者行冠状动脉内多普勒血流速度测定 ,评价这组病人的冠状动脉血流储备功能及其影响因素。方法　对 12 6例冠状动脉造影正常而获得满意血流频谱病人 [男 6 7例 ,女 5 9例 ,平均年龄 (5 3 1± 13 0 )岁 ],采用冠状动脉内多普勒血流速度描记技术对左前降支进行血流速度测定 ,并经冠状动脉内注射腺苷 18μg后测定冠状动脉血流速度储备 (CFVR)。结果　 12 6例病人的左前降支的CFVR平均值为 2 71± 0 74,基础冠状动脉平均峰值血流速度 (bAPV)为 (18 7± 7 2 )cm s,充血相平均峰值血流速度 (hAPV)为 (47 7± 15 2 )cm s。其中6 5 1%的病人CFVR低于 3 0 ,与CFVR正常者 (≥ 3 0 )相比 ,这组病人的bAPV较高而hAPV较低。CFVR与基础心率成负性直线相关 (r=- 0 34 8,P <0 0 0 1) ,而bAPV与基础心率呈正性直线相关 (r =0 376 ,P <0 0 0 1)。CFVR和bAPV与血压均无明显相关关系。有无高血压及高脂血症对CFVR无明显影响。糖尿病患者的CFVR低于无糖尿病的患者 (2 30± 0 47vs 2 80± 0 6 8,P =0 0 44 )。结论　有胸痛但冠状动脉造影正常的病人中约 2 3存在微血管功能障碍 ,冠状动脉血流储备功能受心率的影响 ,糖尿病患者的冠状动脉血流储备功能降低

关键词(KeyWords)： 冠状动脉造影;多普勒;血流储备

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 钱菊英,葛均波,沈学东,DBaumgart,MHaude,RErbel,林佑善,陈灏珠

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