左乳內(nèi)動脈左前降支冠脈旁路移植橋血流量影響因素分析
發(fā)布時間：2019-02-21 17:57
【摘要】：目的探討冠脈旁路移植術(shù)(Coronary artery bypass grafting,CABG)術(shù)中左前降支(Left anterior descending,LAD)靶血管閉塞與未閉塞對橋血管血流量的影響。研究CABG術(shù)中左乳內(nèi)動脈(Left internal mammary artery,LIMA)—LAD橋血管流量高低的影響因素。方法收集2015年10月至2016年7月間行非體外循環(huán)下冠脈旁路移植術(shù)的住院患者212例,其中左前降支閉塞患者50例、左前降支未閉塞患者162例,左前降支分為靶血管閉塞與未閉塞兩組,術(shù)中使用瞬時血流測量(Transit time flowmeter,TTFM)直接測量并記錄左前降支橋血管的橋血流參數(shù)平均血流(Mean graft flow,MGF)、搏動指數(shù)(pulsatility index,PI)、舒張期血流比例(Diastolic filling,DF)。比較左前降支閉塞與未閉塞病人橋血流量。同時記錄患者有無心肌梗死、冠脈狹窄程度、靶血管直徑、性別、年齡、體重、有無高血壓等因素。未閉塞組162例患者按MGF22 mL/min為高流量橋、MGF22mL/min為低流量的標(biāo)準(zhǔn)把橋血流量分為高低2組,分析以上所有因素對左前降支未閉塞LIMA——LAD橋血管高流量低的影響。結(jié)果50例左前降支閉塞患者和162例未閉塞患者的平均血流量分別為(33.21±30.81)和(24.70±20.45)mL/min,PI分別為(2.62±1.31)和(2.93±3.31),左前降支閉塞患者與未閉塞患者的平均血流量和PI無顯著性差異(p=0.067,p=0.441);左前降支閉塞患者的DF(73.34±10.21)與左前降支未閉塞患者(75.39±8.09)(p=0.143)無顯著性差異。對左前降支未閉塞組LIMA—LAD橋血流量高低的影響因素進(jìn)行Logistic回歸分析結(jié)果顯示有心肌梗死LIMA橋平均血流量高(p=0.005)。DF高橋平均血流量高(p=0.001)。冠脈狹窄程度重橋平均血流量高(p=0.037)。結(jié)論1.左前降支閉塞閉塞不影響LIMA—LAD橋血流量。2.無心肌梗死、DF低、狹窄程度低是LIMA-LAD橋血流量低的危險(xiǎn)因素。
[Abstract]:Objective to investigate the effect of left anterior descending branch (Left anterior descending,LAD) target vessel occlusion and non-occlusion on the blood flow of the graft during coronary artery bypass grafting (Coronary artery bypass grafting,CABG). To study the influencing factors of left intramammary artery (Left internal mammary artery,LIMA)-LAD graft flow during CABG. Methods from October 2015 to July 2016, 212 patients underwent off-pump coronary artery bypass grafting, including 50 patients with left anterior descending branch occlusion and 162 patients with left anterior descending artery occlusion. The left anterior descending branch was divided into two groups: the target vessel occlusion group and the non-occlusion group. The mean blood flow parameters (Mean graft flow,MGF) and pulsatile index (pulsatility index,) of the left anterior descending artery were measured and recorded directly by transient blood flow measurement (Transit time flowmeter,TTFM). PI), diastolic blood flow ratio (Diastolic filling,DF). To compare the blood flow between left anterior descending artery occlusion and unoccluded patients. Factors such as myocardial infarction, coronary stenosis, target vessel diameter, sex, age, weight and hypertension were also recorded. According to the criteria of MGF22 mL/min as high flow bridge and MGF22mL/min as low flow rate, 162 patients in non-occluded group were divided into two groups. The influence of all the above factors on the high flow and low flow of left anterior descending branch LIMA--LAD graft was analyzed. Results the mean blood flow of 50 patients with left anterior descending branch occlusion and 162 patients with no occlusion were (33.21 鹵30.81) and (24.70 鹵20.45) mL/min,PI, respectively (2.62 鹵1.31) and (2.93 鹵3.31). There was no significant difference in the mean blood flow and PI between the patients with left anterior descending branch occlusion and those without occlusion (p0. 067 and p0. 441). There was no significant difference in DF between the patients with left anterior descending branch occlusion (73.34 鹵10.21) and the patients without left anterior descending branch occlusion (75.39 鹵8.09) (p = 0.143). The results of Logistic regression analysis showed that the mean blood flow of LIMA-LAD bridge was high in patients with myocardial infarction (p0. 005). DF high bridge) (p0. 001). The mean blood flow of severe coronary artery stenosis was higher (p < 0. 037). Conclusion 1. Left anterior descending artery occlusion did not affect the blood flow of LIMA-LAD bridge. 2. No myocardial infarction, low DF and low degree of stenosis were the risk factors for low blood flow of LIMA-LAD bridge.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R654.2
本文編號：2427750
[Abstract]:Objective to investigate the effect of left anterior descending branch (Left anterior descending,LAD) target vessel occlusion and non-occlusion on the blood flow of the graft during coronary artery bypass grafting (Coronary artery bypass grafting,CABG). To study the influencing factors of left intramammary artery (Left internal mammary artery,LIMA)-LAD graft flow during CABG. Methods from October 2015 to July 2016, 212 patients underwent off-pump coronary artery bypass grafting, including 50 patients with left anterior descending branch occlusion and 162 patients with left anterior descending artery occlusion. The left anterior descending branch was divided into two groups: the target vessel occlusion group and the non-occlusion group. The mean blood flow parameters (Mean graft flow,MGF) and pulsatile index (pulsatility index,) of the left anterior descending artery were measured and recorded directly by transient blood flow measurement (Transit time flowmeter,TTFM). PI), diastolic blood flow ratio (Diastolic filling,DF). To compare the blood flow between left anterior descending artery occlusion and unoccluded patients. Factors such as myocardial infarction, coronary stenosis, target vessel diameter, sex, age, weight and hypertension were also recorded. According to the criteria of MGF22 mL/min as high flow bridge and MGF22mL/min as low flow rate, 162 patients in non-occluded group were divided into two groups. The influence of all the above factors on the high flow and low flow of left anterior descending branch LIMA--LAD graft was analyzed. Results the mean blood flow of 50 patients with left anterior descending branch occlusion and 162 patients with no occlusion were (33.21 鹵30.81) and (24.70 鹵20.45) mL/min,PI, respectively (2.62 鹵1.31) and (2.93 鹵3.31). There was no significant difference in the mean blood flow and PI between the patients with left anterior descending branch occlusion and those without occlusion (p0. 067 and p0. 441). There was no significant difference in DF between the patients with left anterior descending branch occlusion (73.34 鹵10.21) and the patients without left anterior descending branch occlusion (75.39 鹵8.09) (p = 0.143). The results of Logistic regression analysis showed that the mean blood flow of LIMA-LAD bridge was high in patients with myocardial infarction (p0. 005). DF high bridge) (p0. 001). The mean blood flow of severe coronary artery stenosis was higher (p < 0. 037). Conclusion 1. Left anterior descending artery occlusion did not affect the blood flow of LIMA-LAD bridge. 2. No myocardial infarction, low DF and low degree of stenosis were the risk factors for low blood flow of LIMA-LAD bridge.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R654.2
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