冠心病患者肠系膜上动脉造影影像及临床相关性研究

Study on relationship of superior mesenteric angiography images and clinical manifestation in coronary artery disease patients

目的提高对冠心病患者并发肠缺血的认识,完善冠心病防治规划。方法对可疑冠心病心绞痛患者行冠状动脉和肠系膜上动脉造影,分析影像表现,分析冠心病患者的胃肠症状与肠系膜上动脉影像变化的关系。结果59例冠心病患者中17例肠系膜上动脉有病变(28.8%),24例冠状动脉正常者中2例肠系膜上动脉有病变(8.3%),两者比较,差异有统计学意义(P<0.05)。冠状动脉多支血管病变27例(45.8%),合并肠系膜上动脉病变14例(23.7%),单支血管病变32例(54.2%),合并肠系膜上动脉病变3例(0.05%),两者比较,差异有统计学意义(P<0.05)。34例有胃肠症状患者中13例肠系膜上动脉病变(38.2%);25例无胃肠道症状者中4例肠系膜上动脉有病变(16.0%),两者比较,差异有统计学意义(P<0.05)。结论冠状动脉与肠系膜上动脉之间有相关性。肠系膜上动脉损害一般在冠状动脉损害较严重时发生。冠心病患者的胃肠道症状与其肠系膜上动脉血管的改变有关,应重视冠心病患者肠缺血的存在。

Objective To make further cognition of coronary artery disease eompanying mesenterie isehemia and perfect the layout of prevention and cure for coronary artery diseases. Methods Angiograms were performed on the coronary artery and the superior mesenteric artery of shadiness coronary artery disease patients. To analyze the relation of the coronary artery and the superior mesenteric artery, the relation of the ventral clinical symptom and the superior mesenterie artery images. Results Seventeen eases were found lesions in superior mesenterie artery mong 59 eases of coronary artery diseases patients（28.8%）, two eases superior mesenterie artery were found lesions among 24 eases with normal coronary artery （8.3%） （ P 〈 0.05）. Multiple branch coronary artery lesions were found in 27 eases （45.8 %）, uniting superior mesenterie artery lesions in 14 cases（23.7 %） ; single branch coronary artery lesions in 32 cases （54.2%）, uniting superior mesenteric artery lesions in 3 cases（0.05%）（ P 〈0.05）. Among 34 cases with ventral clinical symptom, 13 cases were found lesions（38.2%）; among 25 cases without ventral clinical symptoms, four cases were found lesions （16.0%）（ P 〈 0.05）. Conclusion Superior mesenteric artery lesions are strongly associated with lesions in superior mesenteric arteries. The damages of superior mesenteric artery commonly occurred with severe coronary artery damage, Superior mesenteric artery lesions were strongly associated with ventral clinical symptom in coronary arteries. Importance should be attached to the existence of coronary artery disease companying mesenteric ischemia.