冠状动脉三支病变68例临床分析(英文)

Coronary artery triple vessel lesion: clinical analysis of 68 cases

目的分析冠状动脉三支病变的临床特点,为该类患者的治疗提供理论依据。方法回顾性对比分析经冠状动脉造影明确为冠脉三支病变的患者68例及冠脉单支或双支病变71例的临床资料。结果三支病变组患者与单双支病变组四种高危因素(高血压、高血脂、糖尿病、吸烟)及其聚集性未见显著性差异(P>0.05)。三支病变组运动平板试验的阳性率(23/24)显著高于单双支病变组(26/42,P<0.01),两组侧支循环建立情况及左室造影的LVEF、LVEDP值比较均有显著性差异(P<0.001),三支病变组冠脉病变以IV级为主,发生Ⅲ级和Ⅳ级病变的处数较单双支病变组显著增多,三支病变组48/68例患者接受了介入治疗,但术后心绞痛发生率及需再次行血运重建比例较高。结论条件允许时,冠状动脉三支病变患者目前应首选冠脉搭桥手术(CABG)治疗。

Objective To study the clinical characters of coronary artery triple vessel lesion, and to provide a theoretical basis for the therapy to the disease. Methods The clinical data of 68 cases of coronary artery triple vessel lesion (group A) and 71 cases of coronary artery of single or double vessel lesion (group B) were analyzed retrospectively. Results The related risk factors (hypertension, hyperlipidemia, diabetes and smoking) and the clustering of these factors were not significantly different between the two groups (P>0.05). While the positive rate of the exercise stress test existed remarkable difference between the two groups(P<0.01).The extreme differences between the two groups existed also in the cases of building collateral circulation (P<0.001), and in LVEF and LVEDP (P<0.0001) demonstrated by left ventricular angiography. The majority of the coronary artery lesion in group A was on level Ⅳ, and much more lesions of level Ⅲ and level Ⅳ occurred in group A than in group B. Most patients in group A accepted the coronary intervention, while after operation the angina pectoris emerged in a high rate, then the rebuilding of coronary circulation had to be done. Conclusions The best treatment for the patients with coronary artery triple vessel lesion should be the operation of coronary artery bypass graft (CABG), if it's possible.