不稳定心绞痛453例临床与选择性冠状动脉造影分析

Analysis of Clinical and Selective Coronary Angiography of 453 Cases with Unstable Angina Pectoris

目的 了解不同类型不稳定心绞痛的冠状动脉造影特点（ 冠脉造影） ；方法 ：对４５３ 例不稳定性心绞痛患者进行临床和选择性冠状动脉造影分析；结果 初发劳力型心绞痛以单支病变血管为多见，占６４ ．７１ ％（４４／６８） ，静息型心绞痛以双支及三支病变为多见，分别为２１ ．６ ％ 及５２ ．５８ ％ ，复杂病变及Ｃ型病变检出率较其他各型为高，恶化劳力型心绞痛病变血管介于上述两者之间，梗塞后心绞痛“罪犯”血管多为完全闭塞性病变，较其他类型多见，变异型心绞痛多半仅有轻度及中度冠状动脉狭窄，梗塞后心绞痛血栓检出率较其它各型为高；结论 静息型及恶化劳力型心绞痛病变血管程度较为严重，且病变广泛而复杂，应给予积极治疗，梗塞后心绞痛应加强抗凝或其它有效治疗措施。

Objective To study the characteristics of coronary angiography of patients with different types of unstable angina pectoris. Methods Coronary angiographies and clinical manifestations were analysed on 453 pationts.ResultsSingle vessel disease was more common in neW onset effort angina pectoris(64. 71% 44/68)than in other groups.Bilateral and triple vessel disease were more frequent in patients with rest angina pectoris than in other groups(52.58% and 21.6%)respectively, complex lesions and type C lesions were higher than other types.More than half of the caltuit lesions in early postinfarction angina pectoris were subtotal or total occlusions,being more frequently found than in other groups.Most of the patients with priynzmetae variant angina pectoris had mild coronary lesions only.Coronary thrombi were more frequent in patients with early postinfarction angina pectoris than in the groups of new onset offort angina pectoris,aggravation of effort angina pectoris and prinzmetae variant angina pectoris. Conclusion Coronary thrombi were also more frequent in the patients with rest angina pectoris than in the groups of new onset effort angina pectoris and prynzmetae variant angina pectoris.It is suggested that patients with angina pectoris should be treated more intensively.Strengthened anticoagulation treatment should be given to patients with early postinfarction angina pectoris.