餐后心绞痛的临床研究

A clinical study of postprandial angina

目的 探讨餐后心绞痛临床及冠脉病变的特点。方法 冠状动脉造影证实的冠状动脉性心脏病患者中检出餐后心绞痛的 30例为PP组 ,无餐后心绞痛的 4 5例为NP组 ,与PP组相配对的无餐后心绞痛的 30例为MP组 ,分别进行一般资料、动态心电图、冠状动脉造影资料对比。结果 PP组多见于老年男性 ,多有高血压、心肌梗死史 ,临床表现多为不稳定型心绞痛 ,其 2 4小时缺血总负荷 (TIB)与MP组间差别有显著性意义 (P <0 0 1) ;PP组中左主干 ,三支病变和弥漫性病变的发生率分别为 2 6 7% ,4 6 7%和 36 7% ,与MP组间差别有显著性意义 (P <0 0 5 ) ;PP组冠状动脉旁路移植术 (CABG)有 11例 ,MP组有 3例 ,二者间差别有显著性意义 (P <0 0 5 )。结论 餐后心绞痛是冠心病特殊的临床形式 。

Objective To probe the clinical and angiographical characteristics of patients with postprandial angina.Methods Patients with coronary heart disease(CHD) were divided into three groups,30 patients with postprandial angina(Group PP),45 patients without (Group NP),and 30 patients matched with group PP(Group MP).The data from clinical manifestation, the Holter and the coronary angiography were compared.Results Patients in Group PP tended to be older male, mostly had a history of hypertension, myocardial infarction and often presented with unstable angina pectoris. In contrast with Group MP,the total ischemic burden (TIB) were higher in patients of Group PP(P<0 01).The incidence of left main,three vessel,the diffuse vascular lesion in Group PP were 26 7%,46 7%,36 7% respectively,which were significantly different from Group MP(P<0 05).In Group PP,the coronary artery bypass graft (CABG) was operated on 11 patients,while it was 3 patients in Group MP (P<0 05).Conclusion Postprandial angina is not only a special clinical presence, but also a mark of severity of CHD.