Wellens综合征临床特征研究  

Analysis of clinical features of Wellens syndrome

作　　者：马颖艳[1] 韩雅玲[1] 刘亚斌[1] 武敏 关绍义[1] 

机构地区：[1]沈阳军区总医院心血管病研究所心血管内科,辽宁沈阳110016

出　　处：《临床军医杂志》2015年第7期661-663,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨Wellens综合征患者的危险因素、临床及心电图特点。方法选取自2013年1月至2014年4月我院收治入院的Wellens综合征患者52例,收集所有患者的心电图、心肌酶谱化验、冠脉造影检查,并进行回顾性分析。结果本组52例Wellens综合征患者,平均年龄(56.2±9.92)岁,男性:女性比例1.74∶1,高血压患者29例(55.8%)。治疗后,心肌酶谱标志物较治疗前有所降低,但差异无统计学意义(P>0.05);胸痛发作时,心电图的特征性变化主要表现为T波的改变,其中,T波倒置发生率57.7%,正负双向11.5%;冠脉造影结果显示,前降支病变以近段到中段的狭窄为主,所有血管病变中,发生次全血管闭塞(狭窄>90%)者40例(76.9%),狭窄率<50%者0例。结论年龄、性别、高血压是Wellens综合征发病的危险因素;心电图T波的特征性变化、左前降支近到中段的严重狭窄是鉴别诊断wellens综合征的重要依据。Objective To explore the risk factors, clinical and electrocardiograph （ECG）features of patients with Wellens syn- drome. Methods Totally 52 patients who were hospitalized in local hospital during January 2013 to April 2014 were selected in this study. ECG, cardiac enzyme levels and coronary angiography were performed in all cases, and the clinical data were analyzed respec- tively. Results In all 52 patients, （ 56.2 ± 9.92） years old, the number of male is higher than female （ 1.74 ±1 ）, and 29 cases ac- companied with hypertension（55.8% ）. There was no statistical difference of the cardiac enzyme levels between pre-and post-treat- ment. ECG of patients with Wellens syndrome showed T-wave changes during the chest pain intermittent, with T-wave inversion in 57.7% and T-wave bidirection in 11.5%. The criminal coronary were mainly located in the proximal to middle of LAD, with steno- sis 〉 90% in 40 case（76.9% ）, and 〈 50% stenosis in 0 case. Conclusion Age, gender, hypertension and diabetes are risk fac- tors for Wellens syndrome. The characteristic changes of T wave and severe stnosis in the proximal to middle of LAD are important for the differential diagnosis of Wellens syndrome.

关 键 词：冠脉造影 WELLENS综合征 危险因素 心电图 

分 类 号：R541.61[医药卫生—心血管疾病]