【摘要】 目的 探讨高血压病与冠脉血流储备(CFR)的关系，评价高血压对冠状动脉微血管的影响，以早期诊断原发性微血管心绞痛(PMVA)。方法 选取原发性高血压病且有心绞痛发作的患者65例(高血压3级为A组；高血压1级和2级为B组)为研究对象，另选30例性别、年龄相匹配的健康者为C组。常规超声测量舒张末期左室内径、室间隔厚度及收缩末左房内径等指标，负荷心肌声学造影(MCE)测量冠脉血流储备(CFR)，统计分析各组参数差异性。结果 ①与C组比较，A组和B组收缩末期左房内径(LAD)、室间隔厚度(IVSd)、左室后壁厚度(LVPWd)、平均E/e’均增高，CFR均减低(P<0.001)；②CFR与心肌肥厚呈显著负相关关系(r=-0.719，P<0.001)；CFR与高血压呈显著负相关关系(r=-0.892，P<0.001)。结论 应用超声心动图结合负荷MCE测量CFR，能够评估高血压及心肌肥厚对冠脉微血管的影响，可以在早期诊断PMVA。更多还原

【Abstract】 Objective To investigate the relationship between myocardial hypertrophy and coronary flow reserve(CFR) in patients with hypertension,and evaluate the effect of hypertension on coronary microvasculature,therefore aiding in early diagnosis of primary microvascular angina(PMVA).Methods Sixty five patients with essential hypertension combined with frequent angina pectoris were divided into groups I and Ⅱ according to the degree of hypertension,thirty healthy patients matched for sex and age were selected as the control group.left ventricular end-diastolic diameter,interventricular septal diastolic thickness and left ventricular posterior wall end-diastolic thickness and other parameters were measured using two-dimensional echocardiography.Coronary flow reserve measured by myocardial contrast echocardiography(MCE).The statistical differences in the baseline data were compared between the two groups and control group.Results Compared with the control group,the left atrial end-systolic diameter,interventricular septal diastolic thickness,left ventricular posterior wall end-diastolic thickness and mean E / e’ were higher in two case groups whereas the CFR was lower in both cases groups than those of control group (P<0.001).②decreased CFR was found to be associated with increased hypertrophy(r=-0.719,P<0.001).Hypertension was negatively correlated with CFR(r=-0.892,P<0.001).Conclusion Transthoracic echocardiography combined with MCE can detect CFR in patients with hypertension,assess the impact of myocardial hypertrophy on coronary microvascular function,and contribute to the early diagnosis of PMVA.更多还原