冠状动脉造影正常伴心电图ST段压低患者TIMI帧数分析.docVIP

冠状动脉造影正常伴心电图ST段压低患者TIMI帧数分析 　　作者：韩雅君 　　[摘要] 目的 通过对冠状动脉造影正常而心电图ST段改变与心电图正常患者的TIMI帧数的比较，评价冠状动脉造影正常其心电图ST段改变的可能机制。 方法 63例冠状动脉造影正常心电图表现为ST段水平或下斜型下移≥1.0 mV或运动试验阳性的患者定义为心肌缺血组，冠状动脉造影正常而心电图正常的患者定义为无心肌缺血组。分析2组间的TIMI帧数和ET-1水平。 结果 心肌缺血组患者的TIMI帧数明显长于无心肌缺血组患者，心肌缺血组前降支、回旋支、右冠状动脉的TIMI帧数分别为(40.34±15.22)帧、(29.10±12.05)帧、(20.50±10.13)帧，非心肌缺血组的TIMI帧数值分别为(32.78±10.73)帧，(25.15±9.48)帧，(18.48±8.47)帧，前降支TIMI帧数2组间差异有显著性，而回旋支和右冠状动脉差异无显著性。心肌缺血组的ET-1水平为(31.19±16.17)pg/nl，无心肌缺血组的ET-1水平为(21.09±13)pg/nl，P值为0.02。心电图ST段改变的相关因素有前降支的TIMI帧数(P=0.004)和ET-1(P=0.048)。 　　结论 冠状动脉造影正常而心电图ST段压低的患者冠状动脉血流慢于无心电图改变的患者，血流减慢可能与内皮功能紊乱相关。 　　[关键词] 冠状动脉;血流;心电图 　　Analysis of TIMI frame counts in patients with normal coronary angiography and ST depression 　　HAN Yajun.Department of Cardiology，Inner Mongolia Hospital，Huhhot，010017，China 　　[Abstract] Objective The relationship between coronary flow and myocardial ischemia in electrocardiogram are evaluated through thrombolysis in myocardial infarction frame counts(TFC). Methods 63 patients with normal coronary angiography are divided into two groups.Myocardial ischemia group(MIG) include patients with ST depression ≥1.0 mV in electrocardiogram and positive exercise test.Nonmyocardial ischemia group(NMIG) include patients with normal electrocardiogram and negative exercise test.TFC and levels of endothelium-1(ET-1) are studied. Results TFC of patients in MIG are longer than TFC in NMIG.TFC in MIG are 40.34±15.22 frames in left anterior descending(LAD)，29.10±12.05 frames in left circumflex artery(LCX)，20.50±10.13 frames in right coronary artery(RCA)，and TFC in NMIG are 32.78±10.73 frames in LAD，25.15±9.48 frames in LCX，18.48±8.47 frames in RCA，respectively.There are statistical difference in TFC of LAD，and there are no in LCX and RCA.The levels of ET-1 is 31.19±16.17 pg/nl in MIG and 21.09±13 pg/nl in NMIG，P=0.02.The relative factors of myocardial ischemia are TFC in LAD(P=0.004) and ET-1(P=0.048).Conclusion Coronary flow in patients with normal corona