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目的 :评价冠状动脉血流储备 (CFR)功能的测定对阐明冠状动脉造影正常患者的胸痛机制的临床作用。方法 :4 0例冠状动脉造影正常的胸痛患者分为非心脏病组、X综合征组及高血压组 ,采用TIMI计帧法测定注射罂粟碱前后相关冠状动脉血流帧数的变化 ,并计算CFR。结果 :X综合征组用药前后血流速度均慢于非心脏病组 (P <0 .0 5 ,P <0 .0 1) ,高血压组静息血流速度快于非心脏病组 (P <0 .0 5 )。非心脏病组的CFR范围为2 .0～ 2 .8,X综合征组及高血压组的CFR低于非心脏病组 (P <0 .0 1)。结论 :TIMI计帧法可用于CFR的测定 ,X综合征及高血压患者CFR降低 ,原因可能与冠状动脉小血管的充血反应能力下降和 (或 )基础冠状动脉血流的增加有关
OBJECTIVE: To evaluate the clinical role of coronary flow reserve (CFR) function in elucidating the mechanism of chest pain in patients with normal coronary angiography. Methods: Forty patients with chest pain with normal coronary angiography were divided into non-heart disease group, syndrome X group and hypertension group. The changes of coronary blood flow frame before and after injection of papaverine were measured by TIMI frame method, CFR. Results: The blood flow velocity in group X was lower than that in non-heart group before and after treatment (P <0.05, P <0.01), and the resting blood flow velocity in hypertension group was faster than that in non-heart disease group <0 .0 5). The CFR ranged from 2.0 to 2.8 in non-heart disease patients, and CFR in patients with syndrome X and hypertension was lower than in non-cardiac disease patients (P <0.01). CONCLUSION: The TIMI method can be used for the determination of CFR, and the reduction of CFR in patients with syndrome X and hypertensive patients may be related to the decreased congestive reaction of small coronary arteries and / or the increase of basal coronary blood flow