主动脉瓣关闭不全患者冠状动脉血流灌注的临床观察

目的：探讨主动脉瓣关闭不全对冠状动脉血流灌注的影响。方法i22例主动脉瓣中至重度关闭不全患者（A组）和30例无瓣膜疾病的受试者（B组）均接受经胸超声心动图检查和冠状动脉造影检查。采用TIMI计帧法测量主动脉瓣关闭不全患者冠状动脉血流速度。结果：A组收缩压、脉压差、左心室心肌重量指数（LVMI）、前降支（校正后）、回旋支、右冠TIMI帧数显著高于B组（16．64±2．14）帧vs（12．67±1．68）帧P〈0．05，（24．41±3．43）帧vs（19．23±2．54）帧P〈0．05，（22．13±2．8）帧vs（17．89±2．18）帧P〈0．05]，舒张压、射血分数（EF）低于B组。结论：主动脉瓣关闭不全但冠脉造影正常患者的冠脉血流速度减低，提示冠脉血流灌注不足，可能是导致该病患者发作心绞痛的原因之一。

The clinical observation of coronary flow irrigation in patients with aortic valve insufficiency

Objective： To approach the effect of aortic valve insufficiency （AI） on coronary blood flow perfusion. Methods： Twenty-two patients with moderate to severe AI （group A）and thirty subjects without valve disease （group B） underwent transthoracic echocardiography and coronary arteriography. Using the thrombolysis in myocardial infarction（TIMI） frame count method,we measured the velocity of coronary blood flow in patients with AI. Results： In group A, systolic blood pressure, the index of left ventricular mass （LVMI）,pulse pressure,LAD （corrected）,Cx,and RCA TIMI frame eounts（TFC） were all higher than those of gourp B（16.64±2.14）frame vs （12.67±1.68）frame P〈0.05,（24.41±3.43）frame vs（19.13±2.77）frame P〈0.05, （22.13±2.86）frame vs （17.95±2.47）frame P〈0.05].Diastolie blood pressure and ejection fraction （EF） were lower than those of group B. Conclusion： Coronary blood flow velocity is decreased in patients with AI but normal coronary arteries,which suggest the dificiency of coronary blood flow,and maybe one of the reasons of these patients who suffer from angina.