风湿性心脏病合并冠心病的临床研究  

The clinical study on conary artery disease in adult patients with rheumatic heart disease

作　　者：冯秀华[1] 冯建章[1] 孙家珍[1] 

机构地区：[1]广东省心血管病研究所,广州510100

出　　处：《岭南心血管病杂志》1998年第3期167-169,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的了解我国风湿性心脏病患者的冠心病并发情况及临床特征。方法对本院自1993年～1997年7月40岁以上的已行瓣膜置换手术治疗的风湿性心脏病患者81例的冠状动脉造影及临床情况进行对比研究，男性48例，女性33例，年龄41～69岁，平均55．09±5．85岁。二尖瓣病变者19例，主动脉瓣病变者7例，联合瓣膜病变者55例。结果81例风湿性心脏病患者中有11例的冠状动脉有单支或多支≥50％的狭窄病变，发生率为13．58％，男女之比为2．67：1，多因素回归分析表明风湿性心脏病合并冠心病的发生与瓣膜病变的部位无明显相关性，但与冠心病的危险因素如吸烟，血脂升高，血糖升高等有一定的相关性。结论40岁以上风湿性心脏病患者应常规开展冠心病的危险因素的防治，若出现典型的胸痛，有多种冠心病易患因素存在则高度提示合并冠心病的存在，但由于部分病人为无症状性心肌缺血，因此40岁以上患者术前应常规做冠脉造影检查。Objective To evaluate the prevalence and clinical data of coronary artery disease in adult patients with rheumatic heart disease (RHD). Methods Clinical data and cine - coronary arteriographic finds were studied in 81 consecutive adult patients with rheumatic heart desease from 1993 to July 1997. All the patients underwent routine coronary arteriography, proir to valve replacement, including 48 males and 33 females with a mean age of 55.09 ± 5.85 years, ranging from 41 ~69 and mitral, aortic and combined valvular dieases were in 19, 7 and 55 cases respectively. Results Eleven out of 81 cases (13 .5%) including 8 males and 3 females, had coronary artery disease in at least one vessel with stenosis ≥ 50%, Multiple regression analysis showed that there is a significant positive correlation between risk factors of coronaryartery disewase, such of cigaret, hyperglycemia,hyperlipidemia and risk factors of disease, such of rheumatic heart disease, but no significant correlation between the position of valve lession and coronary artery disease with rheumatic heart disease.Conclusion l, The prevalence of coronary artery disease in adult patients aged over 40 years old with rheumatic heart disease was 13.5% .2, If the patient of rheumatic heart disease pver 40 years old has typical chest pain and some coronary risk factors, it highly indicates coronary heart disease to coexist,necessary to do coronary arteriography for them before surgical therapy.

关 键 词：风湿性心脏病 冠心病 发生率 危险因素 

分 类 号：R541.2[医药卫生—心血管疾病]