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目的 :观察冠状动脉 (冠脉 )造影正常而有冠脉微血管病基础者的三支冠脉血流储备 (Coronaryflowreserve ,CFR)之间是否有差异。方法 :临床上有不典型胸闷或胸痛的患者 4 5例 ,冠脉造影及左室射血分数正常 ,按有无冠脉微血管病基础分为甲、乙两组。甲组为冠脉微血管病组 ,共 2 9例 ,男 19例 ,女 10例 ,年龄 37～ 78(5 8±9.9)岁 ,其中心电图有左室肥厚或劳损表现的高血压患者 11例 ,糖尿病 3例 ,肥厚型心肌病 2例 ,长期吸烟者 10例 ,高血脂 8例 ;乙组为无冠脉微血管病组 ,共 16例 ,男 11例 ,女 5例 ,年龄 38～ 5 8(5 1± 8.6 )岁。冠脉造影过程中随机测定冠脉CFR值 (甲组 6 2支 ,左冠脉前降支 2 4支 ,冠脉左旋支 17支 ,右冠脉 2 1支 ;乙组 36支 ,左冠脉前降支13支 ,冠脉左旋支 8支 ,右冠脉 14支 )。结果 :甲组 6 2支冠脉的平均CFR为 2 .32± 0 .6 1,乙组 3.15± 0 .5 5 ,P <0 .0 1。甲组三支冠脉之间的CFR差异有统计学意义 ,P <0 .0 1;乙组三支冠脉的CFR差别无统计学意义P >0 .0 5。甲组前降支的CFR远低于右冠脉与回旋支 (2 .0 4± 0 .5 2∶2 .5 9± 0 .6 5 ,2 .39± 0 .5 5 ,均 P<0 .0 5 ) ;回旋支较右冠脉的CFR低 ,但差异无统计学意义 (2 .39± 0 .5 5∶2 .5 9± 0 .6 5 ,P >0 .0 5 )。结论 :冠脉微血?
OBJECTIVE: To observe whether there is any difference between the three coronary flow reserve (CFR) patients with normal coronary angiography and those with coronary microvascular disease. Methods: There were 45 cases of clinically typical chest tightness or chest pain, coronary angiography and left ventricular ejection fraction were normal, with or without coronary microvascular disease is divided into A and B groups. A group of coronary microangiopathy group, a total of 29 cases, 19 males and 10 females, aged 37 to 78 (58 ± 9.9) years of age, ECG in which left ventricular hypertrophy or strain performance in 11 patients with hypertension, 3 cases of diabetes mellitus, 2 cases of hypertrophic cardiomyopathy, 10 cases of long-term smokers, 8 cases of hyperlipidemia; Group B without coronary microvascular disease group, a total of 16 cases, 11 males and 5 females, aged 38 ~ 58 5 1 ± 8.6) years old. Coronary angiography during the random determination of coronary CFR values (A group of 62, left anterior descending coronary artery 24, left circumflex coronary artery 17, right coronary artery 21; B group 36, left coronary artery 13 anterior descending artery, left coronary artery 8, right coronary artery 14). Results: The average CFR of 6 2 coronary arteries in group A was 2.32 ± 0.61, 3.15 ± 0.55 in group B, P <0.01. There was a significant difference in CFR between the three coronary arteries in group A, P <0.01; there was no significant difference in CFR among the three coronary arteries in group B (P> 0.05). The CFR of the anterior descending artery in group A was significantly lower than that in the right coronary artery and the circumflex artery (2.04 ± 0.5 vs 2: 5.9 ± 0.56, 2.39 ± 0.55, both P <0 .0 5). The circumflex artery had lower CFR than the right coronary artery, but the difference was not statistically significant (2.39 ± 0.55: 2.59 ± 0.56, P> 0.05). Conclusion: coronary micro blood?