病态窦房结综合征病因的探讨  

Research on etiology of sick sinus syndrome

作　　者：欧阳明刚[1] 欧阳兆兰[1] 欧阳兆强[1] 王敏杰[1] 

机构地区：[1]山东滕州市人民医院心内科,山东滕州277500

出　　处：《中华老年心脑血管病杂志》2003年第3期154-155,共2页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的　探讨选择性冠状动脉造影对病态窦房结综合征病因诊断的临床意义。方法　对 4 2例安置埋藏式心脏起搏器治疗后同时作选择性冠状动脉造影检查的病态窦房结综合征患者进行回顾性分析。结果　 4 2例起搏治疗的病态窦房结综合征患者 ,其中临床诊断冠心病 2 3例 (5 4 .7% ) ,作冠状动脉造影检查证实达到冠心病阳性诊断标准的冠状动脉狭窄患者 5例 (11.9% ) ,其中单支病变 3例 (左前降支 2例 ,右冠状动脉 1例 ) ,双支病变 2例 (左前降支加左回旋支 1例 ,左前降支加右冠状动脉 1例 )。全部病例均可见窦房结动脉清晰显影 ,未见狭窄病变。右冠状动脉及左回旋支有狭窄部位均在窦房结动脉发出以后 ,未累及窦房结动脉。结论　冠状动脉造影有助于病态窦房结综合征患者的病因诊断 ,但冠心病并非本组病态窦房结综合征的主要病因。Objective To study the significance of selected coronary arteriography in etiological diagnosis of sick sinus syndrome (SSS).Methods Forty-two patients with SSS who had received treatment with implanted pacemaker and selected coronary arteriography were retrospectively analyzed.Results Of 42 cases of SSS with pacemaker,23 (54.7%) were clinically diagnosed as coronary heart disease,5 (11.9%) was confirmed by coronary arteriography to have coronary stenosis which came up to the positive diagnostic criteria for coronary heart disease.Of the 5 patients,3 had monobranch lesion(2 had left descending anterior branch lesion and 1 had right coronary artery lesion), 2 had bibranch lesions(1 had lesions of left descending anterior branch and left circumflex branch, 1 had lesions of left descending anterior branch and right coronary artery).Distinct image of sinus artery was seen in all patients and no stenosis could be seen.Stenosis in right coronary artery or left circumflex branch took place at the site after the sinus artery had branched off and the sinus artery was not involved.Conclusion Coronary arteriography is helpful to etiological diagnosis of patients with SSS but coronary heart disease is not the main cause of SSS in this group.

关 键 词：窦房结 心脏起搏 人工 冠状血管造影术 诊断 

分 类 号：R541.7[医药卫生—心血管疾病]