不稳定型心绞痛并发的室性心动过速及介入治疗对其的影响  

Characteristics of ventricular tachycardia coexisting with unstable angina pectoris and the efficacy of percutaneous coronary intervention on it

作　　者：陈良华[1] 刘同宝[1] 姜慧珍[1] 唐元升[1] 刘继东[1] 崔连群[1] 朱兴雷[1] 

机构地区：[1]山东省立医院心内科,山东济南250021

出　　处：《中国心脏起搏与心电生理杂志》2006年第2期132-134,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨不稳定型心绞痛并发的室性心动过速(简称室速)特点以及经皮冠状动脉(简称冠脉)介入治疗对其的影响。方法对10例不稳定型心绞痛患者并发的室速,通过心电图观察室速发生前ST段的变化。行冠脉造影及介入治疗,了解室速特点与冠脉病变的关系。通过临床随访包括动态心电图观察室速发作情况。结果6例变异型心绞痛患者并发的室速在冠脉闭塞期出现,均为单一前降支病变;4例混合型心绞痛患者并发的室速,2例出现在ST段压低最深时,另2例则出现ST段逐渐变浅时,均为多支冠脉病变。10例均成功地接受了介入治疗。在10个月至4.1年的随访过程中,10例均未出现室速和临床再狭窄。结论不稳定型心绞痛并发的室速可能是缺血及再灌注损伤引起,ST段下移所致室速的患者冠脉病变可能更为复杂、严重。介入治疗可控制这类室速的发作。Objective To evaluate the characteristics of ventricular tachycardia （VT） coexisting with unstable angina pectoris and the efficacy of percutaneous coronary intervention （PCI） on it. Methods Among ten patients with VT coexisting with unstable angina pectoris, the ST segment changes were observed before VT attack by electrocardiogram. All patients received coronary angiography and PCI, and the relationship between the characteristics of VT and coronary lesions was investigated. The recurrences of VT were monitored through clinical follow-up including dynamic electrocardiography. Results Coexisting VT in 6 patients with variant angina occurred during coronary occlusion with a single left anterior descending artery lesion. Among 4 patients with complex angina,coexisting VT in 2 patients occurred on maximal depression of ST segment, while VT in the other 2 patients occurred during gradual resolution of ST segment, and all with multi-vessel lesions. All patients received successful PCI. During the follow-up of 10 months to 4.1 years, all 10 patients showed no recurrence of VT and no clinical restenosis. Conclusions VT coexisting with unstable angina pectoris may be induced by ischemia and reperfusion injury. Coronary lesions of the patients with VT due to ST depression may be severe and complicated. PCI can control this type of VT.

关 键 词：心血管病学 冠状动脉疾病 室性心动过速 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病] R541.71[医药卫生—内科学]