卧位心绞痛的临床及冠状动脉造影特点  

CLINICAL AND CORONARY ANGIOGRAPHIC FEATURES OF PATIENTS WITH ANGINA DECUBITUS

作　　者：刘现亮[1] 刘科卫[1] 尤乃祯[1] 

机构地区：[1]济南军区总医院心内科,济南250031

出　　处：《中国现代医学杂志》2002年第12期51-52,55,共3页China Journal of Modern Medicine

摘　　要：目的 :观察卧位心绞痛的临床及冠状动脉造影病变特点。方法 :选择 30例卧位心绞痛患者 (A组 ,其中2 3例行冠脉造影 )及 4 2例稳定劳力型心绞痛患者 (B组 ) ,比较两组患者的临床及冠脉造影特征。结果 :A组患者年龄较B组患者大 ,A组患者中 2 5例 (83% )合并高血压 ,13例 (43% )合并糖尿病 ,均明显高于B组 (P值分别为 <0 .0 1、<0 .0 5 ) ,A组患者有心肌梗塞病史者更多 (分别为 6 3%与 19% ,P <0 .0 1)。A组异常室壁运动检出率 (73% )明显高于B组 (2 4 % ,P <0 .0 1) ,EF <0 .4 5的检出率两组间无明显差异。A组患者 91%有3支病变、34%有左主干病变 ,均明显高于B组 (分别为 14 %、2 % ,P均 <0 .0 1) ,而且病变狭窄程度更重。A组 78%的患者为C型病变 ,而B组患者仅 17% ,差异显著 (P <0 .0 1)。结论 :卧位心绞痛患者年龄较大 ,大多伴有高血压、糖尿病及心肌梗塞病史 ,其临床病情及冠脉病变严重 ,大多数患者为 3支和 /或左主干血管病 ,冠脉血流储备严重不足。Objective:To investigate the clinical and coronary angiographic features of patients with angina decubitus. Methods:Thirty patients with angina decubitus (group A,coronary angiographies were performed in 23 of 30 patients) and 42 patients with stable exertional angina (group B) were selected. The clinical and coronary angiographic features of patients in the two groups were compared. Results:Compared with stable exertional angina (group B), patients with angina decubitus (group A) were older(68±5 years vs 60±12 years, P <0.01). There were more patients combining with hypertension and diabetes mellitus in group A than in group B(83% vs 45%; 43% vs 17% respectively; both P <0.05).More patients had a history of myocardial infarction in group A than in group B(63% vs 19%, P <0.01).The incidence of abnormal ventricular wall movement by echocardiography in group A(73%) was higher than in group B (24%)( P <0.01),but the incidence of EF<0.45 was similar between the two groups( P >0.05).Three-vessel disease and left main disease were found in 91% and 34% of patients in group A respectively, both of which were higher than in group B (14% and 2% respectively, both P <0.01).Moreover, the stenostic degrees of lesions in group A were highly severe than in group B.Type C lesions were found in 18 of 23 cases (78%) in group A,but only in 7 of 42 cases (17%) in group B( P <0.01). Conclusions:Patients with angina decubitus are older, mostly accompanied by hypertension, diabetes mellitus and myocardial infarction before. The clinical presentations and angiographic lesions of the patients are severe. Most of them present three-vessel disease and/or left main vessel disease, which indicates that the preservation of coronary flow of the patient with angina decubitus is insufficient severely.

关 键 词：卧位心绞痛 稳定劳力型心绞痛 冠状动脉造影术 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]