不伴心肌梗死的冠状动脉完全闭塞病变心绞痛的临床分析  

The Clinical Character of Angina Pectoris with Coronary Total Occlusion with-out Myocardial Infarction

作　　者：陈辉民 孙尧[2] 刘铭雅[3] 蔡迺绳[3] 

机构地区：[1]福建省厦门同安区医院在中山医院的进修生,361100 [2]华北煤炭医学院附属医院在中山医院的进修生,063000 [3]复旦大学附属中山医院心内科,上海200032

出　　处：《中国临床医学》2002年第2期147-148,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨不伴心肌梗死的冠状动脉完全闭塞病变心绞痛患者的临床特点。方法:对24例不伴心肌梗死的冠状动脉完全闭塞患者的临床表现、心电图、超声心动图及冠状动脉造影资料进行回顾分析。结果:中、高危险组主要表现为静息心绞痛,低危险组和稳定性心绞痛组主要表现为劳力型心绞痛。冠状动脉造影显示左前降支闭塞10例（37％）,右冠状动脉闭塞7例（26％）,左回旋支闭塞6例（22％）,合并多支血管病变23例（95.8％）。心电图ST段异常14例（58.3％）。62.5％的患者进行经皮冠脉血运重建术。结论:不伴心肌梗死的冠状动脉完全闭塞主要表现为劳力型心绞痛,心电图ST段异常是预测冠脉病变严重程度的主要危险因素。经皮冠状动脉介入治疗正成为慢性冠状动脉闭塞的主要手段之一。Objective: To observe the clinical characteristic of angina pectoris with coronary total occlusion without myocar-dial infarction. Methods: 24 patients of angina pectoris with coronary total occlusion without myocardial infarction were classi-fied into high ,moderate and low risk groups and stable angina group. The clinical situation ECG echocardiogram and coronary angiography were reviewed. Results: Moderate and high risk groups were mainly present as rest angina pectoris. low risk group and stable angina group were present as exertional angina. The coronary angiography showed 10 patients(37%)with left anterial descending artery occlusion ,7 patients(26%) with right coronary artery occlusion,6 patients(22%) with left circum-flex artery occlusion. 23 patients(95.8% ) with multi - vessels involved. ECG showed 14 patients(58. 3%) with abnormal ST segment. 62.5% of the patients received PTCA and stent treatment. Conclusion: Patients of angina pectoris with coronary to-tal occlusion without myocardial infarction were mainly present as exertional angina. Serious lesion can be identified by abnor-mal ST segment of ECG. PTCA is becoming the most common treatment of chronic coronary occlusion.

关 键 词：冠状动脉造影 心绞痛 冠状动脉完全闭塞病变 临床分析 

分 类 号：R541.4[医药卫生—心血管疾病]