冠状动脉慢血流与冠状动脉管腔特征的相关性研究

摘要

目的：探讨冠状动脉慢血流（SCF）与冠状动脉管腔特征的相关性。　　方法：回顾2012-08至2014-04在潍坊市人民医院心内一科行冠状动脉造影的2117例患者的造影结果，通过校正的心肌梗死溶栓治疗临床试验（TIMI）计帧法，从中筛选出冠状动脉狭窄小于50%且存在SCF现象，同时排除冠状动脉血栓、扩张、夹层等病变的患者110例，作为SCF组，另外同期选择冠状动脉造影结果正常的患者49例作为对照组，分别测量两组患者的左主干内径（dLM）、左前降支近端内径（dLADp）、左前降支中段内径（dLADm）、左回旋支近端内径（dLCXp）、左回旋支中段内径（dLCXm）、右冠状动脉近端内径（dRCAp）、右冠状动脉中段内径（dRCAm），并分别计算各支血管近端内径与中段内径的比值（dLADp/m、dLCXp/m、dRCAp/m）。　　结果：两组患者的dLADp/m、dLCXp/m及dRCAp/m差异无统计学意义（P>0.05），而SCF组患者的dLM、dLADp、dLADm、dLCXp、dLCXm、dRCAp、dRCAm均大于对照组，差异有统计学意义（P<0.05）；Pearson相关分析显示冠状动脉各支血管血流帧数与该血管的近、中段内径均呈正相关（相关系数分别为：左前降支0.036及0.204，左回旋支0.368及0.183，右冠状动脉0.253及0.209，P均<0.05），左冠状动脉平均血流帧数与左主干内径呈正相关（相关系数为0.501，P<0.05）。　　结论：冠状动脉左前降支、左回旋支、右冠状动脉三支血管血流帧数的增加与该血管内径的增大有关，左、右冠状动脉内径的增大可能在SCF现象的发生发展中起到促进作用。%Objective: To explore the relationship between slow coronary lfow (SCF) and characteristics of coronary lumen condition in relevant patients. Methods: We retrospectively summarized 2117 patients who received coronary angiography (CAG) in Weifang people’s hospital from 2012-08 to 2014-04 and 2 groups of patients were enrolled in our study. SCF group, according to TIMI frame count, the patients had coronary stenosis<50%, without coronary thrombosis, expansion and dissection,n=110. Control group, the patients had normal CAG at meanwhile,n=49. The diameters of left main (dLM), left anterior descending proximal section (dLADp) and middle section (dLADm), left circumlfex (dLCXp) and dLCXm, right coronary artery (dRCAp) and dRCAm were measured; the ratios of dLADp/dLADm, dLCXp/dLCXm, dRCAp/dRCAm were compared between 2 groups. Results: The ratios of dLADp/dLADm, dLCXp/dLCXm, dRCAp/dRCAm were similar between 2 groups,P>0.05. Compared with Control group, SCF group had increased dLM, increased dLADp and dLADm, dLCXp and dLCXm, dRCAp and dRCAm, allP<0.05. Pearson correlation analysis showed that coronary TIMI frame counts were positively related to the diameters of distal and middle sections of each vessel, the correlation coefifcients in LAD were 0.036 and 0.204, in LCX were 0.368 and 0.183, in RCA were 0.253 and 0.209, allP<0.05. Left coronary TIMI frame count was positively related to the diameter of LM, the correlation coefifcient was 0.501,P<0.05. Conclusion: Elevated coronary TIMI frame count was related to increased vessel diameter, the expended diameter of left and right coronary arteries may promote SCF development in relevant patients.