卧位型心绞痛的血液动力学变化

目的　观察卧位型心绞痛患者心功能状态及其在容量负荷后的变化。方法　选择 2 5例卧位型心绞痛患者 ,行胸片、UCG、ECT、Swan Ganz导管检查及容量负荷试验 ,并与 2 3例混合型心绞痛及 2 2例恶化劳累型心绞痛患者比较分析。结果　① 2 5例卧位型心绞痛中 ,舒张功能不全占 4 8% ,收缩功能不全占 32 % ,心功能正常占2 0 %。容量负荷试验阴性、阳性分别为 14、11例。②与混合型心绞痛、恶化劳累型心绞痛相比较 ,卧位型心绞痛患者的心胸比例、CAI、PCWP及CI皆明显异常。③卧位型心绞痛者负荷试验阴性、阳性比较 ,心胸比例、CAI、EF、PER、PFR、CI均有显著差异 (P <0 .0 1及P <0 .0 5 ) ,而Lee氏心功能计分法、mPAP、PCWP无显著差异 (P >0 .0 5 )。结论　卧位型心绞痛的平均心功能差 ,其中收缩功能不全者并不少见。当心脏明显扩大时 ,应加强强心、利尿治疗

Hemodynamic changes in patients with angina decubitus

Objective To study the state of heart function and the change after volume loading test in the patients with angina decubitus(AD). Methods Twenty five of AD as group A were observed by X ray, echocardiography, ECT, hemodynamics and volume loading test, and compared with twenty three of mixed angina as group B and twenty two of accelerated angina as group C. Cardiothoracic ratio (CR), CAI, EF, mPAP, PCWP and CI were examined in the three groups. Results ① Systolic and diastolic dysfunctions were present in the patients with AD; ② CR, CAI, mPAP and PCWP increased significantly ( P <0.05),but CI decreased ( P <0.05) in group A as compared with those in group C. mPAP, and PCWP in group A were higher than those in group B, but there were no significant difference in CR, CAI and CI ( P >0.05); ③ In the negative reaction group and positive reaction group which reacted to volume loading test differently, CR, CAI increased significantly ( P <0.01) and EF, PER, PFR, and CI reduced ( P <0.05) in the positive group. But Lee's method of counting scores, mPAP and PCWP in both groups had no significant difference ( P > 0.05 ).Conclusion There are systolic and diastolic dysfunctions in the patients with AD; diastolic dysfunction is obvious in the patients with normal CR and CAI in negative reaction group and need Ca 2+ antagonist and/or β blocker. But there is systolic dysfunction in the patients with positive reaction when their heart dilate. Treatment with cardiac tonic and diuretic are necessary.