老年冠心病患者冠状动脉病变对左心重构的影响

摘要

Objective To explore the influence of coronary artery disease on left ventricular remodeling in elderly patients with coronary artery disease. Methods 171 cases of senile patients with coronary artery disease who finished the examination of coronary angiography from Jan 2002 to Jan 2010 were investigated, including 76 patients with history of AMI and 95 patients without history of AMI, according to left ventricle size, they were divided into 43 patients with enlarged left ventricle and 128 patients without enlarged left ventricle. Collected those patients'data of cardiac ultrasound and coronary angiography to calculate the Gensini score, and then investigated the influence of coronary artery disease on left ventricular remodeling. Results ( 1 )There were significant differences of LVEDD, LVESD, FS, AOD and LAD between patients with or without myo-cardial infarction history( P <0. 05, P < 0. 01 ). The Gensini score were correlated with LVEDD, AOD and LAD( P < 0.01 ) but not with LVESD and FS( P >0. 05 ). ( 2 )Compared with patients without enlarged left ventricle, patients with enlarged left ventricle has higher incidence of anterior descending branch lesion, left coronary leision, multiple lesion, diffusive lesion and totally obstructive lesion, there was significant difference( P <0. 01 ). Conclusion Coronary artery disease is the main reason of left ventricular remodeling in senile patients.%目的 探讨老年冠心病患者冠状动脉病变对左心重构的影响.方法 2002年1月-2010年1月住院并完成冠脉造影的老年冠心病患者171例,其中有陈旧性心肌梗死病史患者76例,无陈旧性心肌梗死病史患者95例,按是否有左心室扩大分为左心室扩大组43例,无左心室扩大组128例,采集患者心脏超声数据及冠脉造影资料,计算冠状动脉Gensini积分,分析冠状动脉病变对左心重构的影响.结果 (1)无心肌梗死病史患者和有心肌梗死病史患者比较,LVEDD、LVESD、FS、AOD、LAD差异均有统计学意义(P<0.05,P<0.01),2组冠状动脉Gensini积分均与LVEDD、AOD、LAD均呈正相关性(P<0.01),与LVESD、FS均无相关性(P>0.05).(2)左心室扩大组与无左心室扩大组比较,前降支病变、左冠状动脉病变、多支病变、弥漫病变及完全闭塞病变发生率差异均有统计学意义(P<0.01).结论 老年冠心病患者冠状动脉病变是左心室重构的重要原因.