冠脉闭塞性病变56例临床分析

Clinical analysis of 56 cases with coronary artery total occlusions

目的总结分析我科近年来冠脉造影显示冠脉闭塞性病变病例,提高对该病的深入认识。方法收集1996年8月～2003年12月冠脉造影显示冠脉闭塞性病变56例,对其加以临床分析。结果1)男54例,女2例。发病年龄32～74岁,40岁以下2例,70岁以上3例。2)AMI病史或OMI病史49例。无心肌梗死病史,仅心绞痛病史7例,其中恶化劳累型心绞痛5例,稳定劳累型心绞痛2例。3)冠脉闭塞血管分布,LAD27例,于D1前闭塞4例,D1后闭塞23例,LCX4例,RCA29例,其中开口或近端18例,中段6例,远端(三叉前或累及PL、PD闭塞)5例。单支闭塞52例,双支闭塞4例,其中RCA+LAD闭塞3例,LAD+LCX闭塞1例。4)冠脉侧支循环形成33例,无侧支形成23例。结论冠脉闭塞性病变多发生于有心肌梗死病例,少数在心绞痛病例亦有出现,闭塞血管多分布于RCA及LAD,LCX较少,多出现单支血管闭塞,少数双支血管闭塞。

Objective To disscuss the cases with coronary artery total occlusions showed by coronary angiography in recent years in order to further recognize this kind of disease. Methods Collected 56 cases with coronary artery total occlusions from Aug 1996 to Dec 2003, of whom showed by coronary angiography ,and make the clinical analysis. Results 1, 54 cases are male, 2 cases are female, The age ranged from 32 to 74 years, of whom 2 cases 〈40 and 3 cases 〉70. 2,49 cases with AMI or OMI medical history. 7 cases with angina history, of whom 5 cases with accelerated effort angina and 2 cases with stable effort angina. 3, Distribution of the occlusive vessels, 27 cases at LAD, of whom 4 cases occlusion before D1, and 23 cases occlusion after D1, 4 cases at LCX, 29 cases at RCA, of whom 18 eases located at the ostium or proximal, 6 cases located at the middle, 5 cases located at the cerminal. 52 patients had one-vessel occlusion. 4 patients had two-vessels occlusions. 4, 33 patients had collateral circulation and 23 without collateral circulation. Conclusions Most of the coronary occlusive lesions happened in the patients with myocardial infarction, and a few lesions in the patients with angina. The occlusive vessels were likely in the RCA and LAD. Most of cases presented the single vessd occlusion and a few patients presented 2-vessels occlusion.