ST段抬高为特点的劳力型心绞痛患者的冠脉造影和冠脉成形术治疗  

The coronary angiography and PTCA of effort angina patients characterized with ST segment elevation

作　　者：江洪[1] 黄从新[1] 唐其柱[1] 黎明江[1] 许家琍[1] 王晋明[1] 漆曙辉[1] 王小红[1] 李庚山[1] 

机构地区：[1]湖北医科大学附属第一医院心内科

出　　处：《临床心电学杂志》1999年第1期10-13,共4页Journal of Clinical Electrocardiology

基　　金：湖北省九;五攻关项目资助

摘　　要：目的报道４例以ＳＴ段抬高为特点的劳力性心绞痛患者，探讨其冠脉病变特点和冠脉成形术（ＰＴＣＡ）治疗效果。方法术前行平板运动试验或记录心绞痛发作时的心电图，全部病例接受冠状动脉造影和ＰＴＣＡ术，术后作平板运动试验。结果４例患者以活动、焦虑、紧张为其心绞痛发作主要诱因，心电图特点为相应导联ＳＴ段抬高０．１～０．４ｍＶ。停止运动后心绞痛消失，ＳＴ段恢复正常。冠脉造影４例为单支病变，８０％～９０％狭窄，远端无侧支循环，经球囊成形术后置入支架，术后心绞痛消失，运动试验阴性。结论本文病例的临床特点和冠脉造影结果提示属劳力型心绞痛的少见类型，因具有病情进展快，心肌缺血严重且伴有心电不稳定和冠脉狭窄严重等特点，实为不稳定心绞痛。因此在药物治疗基础上考虑非药物治疗有重要意义，本文结果亦证实ＰＴＣＡ或同时置入支架可完全缓解心绞痛和心肌缺血的心电表现。Objective 4 cases with effort angina characterized with ST elevation were studied on the features of coronary lesion and PTCA treatment.Methods The treadmill exercise test was performed before and after PTCA.ECG was recorded while angina attacked.All patients received coronary angiorgraphy and PTCA.Results Activity,anxiety and tensity were main precipitating factors of angina while the ST segment elevated 0 1～1 4mV on relevant leads.All of four patients were showed single vessel lesion of 80%～90% stenosis without distal bilateral vessel were by angiography.Angina disappeared after PTCA or stenting and exercise tests turned to negative.Conclusion the clinical characteristics and angiography suggested these patients suffered a rare type of effort angina which developed fast,accompanied unstable cardiac electricity and had severe coronary stenosis.Nonmedicine treatment such as PTCA or stenting played a important role in releasing angina and ameioliated ECG manifestation of ischemia.

关 键 词：ST段抬高 劳力型 心绞痛 血管造影 冠脉成形术 

分 类 号：R541.405[医药卫生—心血管疾病]