风湿性瓣膜病患者冠状动脉疾病预测指标的研究

Result of the coronary angiography of acquired rheumatic valve disease

目的 :研究风湿性瓣膜病患者冠状动脉心脏病 (CHD)的冠状动脉病变分布及CHD预测指标。方法 :对 6 78例风湿性瓣膜病患者行冠状动脉造影检查 ,左右冠状动脉管腔狭窄≥ 70 %、左主干管腔狭窄≥ 5 0 %判定为CHD。结果 :发现并发有CHD患者 (CHD组 ) 86例 ,平均年龄大于非CHD患者 (非CHD组 ) ,多支病变 4 8例(5 5 .81% )。CHD组中家族史、糖尿病、高胆固醇血症多于非CHD患者。有无心绞痛症状与是否并发CHD无明显相关 ,各种瓣膜病变CHD的发生率相似。结论 :CHD家族史、糖尿病、高胆固醇血症是风湿性瓣膜病患者进行冠状动脉造影检查的指征 。

Objective:To study the distribution of coronary artery lesion and identify predictors of coronary heart disease (CHD) in patients with rheumatic valvular heart disease. Method:There were 678 consecutive patients with rheumatic valvular heart disease were performed coronary angiography from Dec. 1994 to Dec. 2003 in our hospital,there were 426 male and 252 female with mean age (57± 6.4) year. Significant CHD was defined as stenoses over 70% of artery lumen in relation to artery diameter before lesion and over 50% for left main coronary artery. Result:Eighty-six patients( 12.68%,56 men,30 women) detected with CHD were older than those without CHD. The distribution of significant coronary lesions in 48 patients ( 55.81%) was multi-artery. With respect to coronary risk factors, family history of CHD,diabetes mellitus and hypercholesterol were significantly more frequent in CHD + group as compared to the CHD - patients. Angina had no significant relation to CHD in this group. No relation was found between the rheumatic disease and coronary disease distribution, but the left main disease was only seen in the patients with aortic valve regurgitation. Conclusion: 12.68% of patients with acquired rheumatic valve disease is associated with coronary artery disease. Most of them are with multi-artery lesion. It is necessary to indicate coronary angiography to those with family history of CHD,diabetes mellitus and hypercholesterol.