慢性完全冠状动脉堵塞患者心肌梗死发生与否与侧枝血管的关系  

Relationship between collateral vessels and incidence of myocardial infraction in patients with chronic total coronary occlusion

作　　者：李若谷[1] 杨栓锁[1] 汤磊[2] 曲新凯[1] 干倩[1] 

机构地区：[1]上海交通大学附属胸科医院心内科,上海200030 [2]上海交通大学医学院医院管理处,上海200025

出　　处：《上海交通大学学报（医学版）》2013年第5期651-654,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的观察慢性完全冠状动脉堵塞患者心肌梗死发生率并探讨侧枝血管与其发生的关系。方法回顾性分析256例慢性完全冠状动脉堵塞(堵塞时间≥3个月)患者的病史、心肌酶谱及心电图后,将其分为心肌梗死组和非梗死组,比较两组患者的一般临床情况、药物治疗情况、堵塞血管的位置分布和支数、非堵塞血管病变位置分布和严重程度以及冠脉造影侧枝血管Rentrop分级的差异。结果梗死组138例(53.9%),非梗死组118例(46.1%)。两组患者的基线情况如性别、年龄、患糖尿病、高血压、血脂异常、吸烟以及药物治疗之间差异无统计学差异(P>0.05);堵塞冠脉位置分布及堵塞血管支数无统计学差异(P>0.05);非堵塞冠脉病变位置分布和病变严重程度无统计学差异(P>0.05);侧枝血管分级两组之间差异无统计学差异(P>0.05)。结论冠状动脉慢性完全堵塞时间超过3个月,不论其供应的心肌是否有梗死发生,侧枝血管分级亦无差异。Objective To investigate the incidence of myocardial infraction in patients with chronic total coronary occlusion, and explore its relationship with collateral vessels. Methods The medical history, myocardial enzyme and electrocardiogram in 256 patients with chronic total coronary occlusion（ occlusion duration ≥3 months） were retrospectively analysed. Patients were divided into myocardial infarction group and non-infarction group, and the basic characteristics, drug therapies, distribution and extent of occluded blood vessels, lesion distribution and severity of unoccluded vessels and the collateral vessel grade of Rentrop classification on coronary artery angiogram were compared between groups. Results There were 138 （53.9%） patients in myocardial infraction group and 118 （46.1%） patients in non-infarction group. There was no significant difference between two groups in age, gender, diabetes, hypertension, hyperlipidemia, smoking history and drug therapies （P 〉 0.05）. There was no significant difference in the distribution and extent of occluded blood vessels between two groups （ P 〉 0.05）. Similarly, there was no significant difference in the lesion distribution and severity of unoccluded vessels between two groups （P 〉 0. 05）. Besides, there was no significant difference in the collateral grade between two groups （P 〉 0.05）. Conclusion When chronic total coronary occlusion lasts for more than 3 months, there may be no difference in the grade of collateral vessels regardless of the incidence of myocardial infraction of myocardium supplied by the occluded artery

关 键 词：慢性完全冠状动脉堵塞 心肌梗死 侧枝血管 

分 类 号：R541.4[医药卫生—心血管疾病]