Wellens综合征临床观察  

The Clinical Effect of Wellens Syndrome

作　　者：胡秋玲[1] 李晟琰[1] 张莉[1] 马葆琛[2] 

机构地区：[1]哈尔滨二四二医院,哈尔滨150066 [2]哈尔滨工程大学医院,哈尔滨150001

出　　处：《航空航天医学杂志》2014年第5期611-613,共3页Journal of Aerospace medicine

摘　　要：目的：观察Wellens综合征的临床特点及诊疗常规。方法2008年1月～2012年12月收治的Wellens综合征患者52例。平均随访10.20±13.22个月，观察其心绞痛发作的特点、心电图演变的特点、超声心动图特点、心肌生化标记物水平、.冠脉造影特点及预后。结果①20例患者在一月内支架治疗，3例择期搭桥，29例未接受经皮冠脉介入治疗（ PCI ）手术及冠状动脉旁路移植术（ CABG ）手术治疗的患者，其中6例随访期间接受PCI，7例（24.13％）进展为急性ST段抬高型心肌梗死，其中有1例（3.45％）发生猝死；②心电图T波演变：其中36例心电呈伪善性改变，18例ST段轻度抬高，16例表现为T波倒置或双向。③超声心动图：28例记录到室壁运动障。④心肌生化标记物水平：心肌肌钙白升高者27例，6例肌钙蛋白轻度增高。⑤52例冠脉病变均位于前降支近中段，35例患者前降支有侧枝循环。结论对于Wellens综合征，正确识别心电图，尽早介入或搭桥治疗，患者可从中获益。Objective To explore the clinical features , Diagnosis and treatment and conventional of patients diag -nosed Wellens syndrome.Methods 52 patients with Wellens syndrome.from January 2008 to Deceber 2012 were Our hospital,The average follow-up 10.20 ±13.22 months, and all of them had the consecutive The characteristics of heart attacks ,The characteristics of electrocardiogram （ ECG ） evolution and ultrasonic cardiogram （ UCG ） characteristics and Myocardial biochemical markers level ,and Coronary angiography characteristic and outcome.Results ①Heart attacks time More than 20 minutes,The 20 cases had PCI in one month,3 cases had coronaryartery bypass grafting （CABG）,and 29 cases without PCI or CABG , and 6 cases among them accepted PCI ,7 cases（24.13%）developed into ST elevation a-cute myocardial infarction and one cases （3.45%） of them had sudden cardiac death.②The cardiac troponin Tlevel：36 cases of changes in ECG hypocrisy , 18 patients with st-segment mild elevations ,16 cases of performance for T wave the cart before the horse or two -way,and ,From heart attacks are not synchronizedand Many appear in angina pectoris ease after several hours or days.③UCG dyskinesia of the left ventricle were found in 28.④Myocardial biochemical markers level The elevated cardiac troponin calcium white 27 cases;6 cases for troponin increased slightly.⑤The criminal coro-nary artery in 52 cases located in the proximal and middle of the LAD （100%）,with stenosis＆gt;90%in 8 cases,70%-90%stenosis in 36 cases,and 50%-70%stenosis in 6 cases,and 30%-50%stenosis in 2 cases,and〈30%stenosis in 0 cases,there were 35 cases had collateral circulation to LAD.Conclusions A profound understanding of Wellens syndrome,acutePCI or CABG,Patients can benefit from it.

关 键 词：WELLENS综合征 不稳定心绞痛 左冠状动脉前降支T波综合症 

分 类 号：R541.4[医药卫生—心血管疾病]