不同冠状动脉病变范围患者的临床特征与心脏状况分析

Clinical features and heart state in different coronary artery disease.

目的探讨冠心痛患者不同冠状动脉病变范围的临床特征,为冠状动脉粥样硬化性心脏病防治提供临床全面证据。方法404例冠状动脉造影的患者按其冠状动脉受累情况分为4组:无冠状动脉病变组124例、单支病变组102例、双支病变组91例、三支病变组87例,观察对比一般临床状况、临床相关生化指标及心脏结构和功能的状况等临床特征。结果随冠状动脉病变侵犯血管支数的增加,患者年龄增加,合并高血压病、糖尿病、陈旧性心肌梗死增加,其中以糖尿病病变最显著;血生化指标中尿酸、肌酐、空腹血糖水平升高;左心房扩大、心功能减退增加,其中女性患者心脏结构多项指标改变明显。结论年龄、有无合并高血压病、糖尿病、陈旧性心肌梗死可影响冠状动脉病变范围;尿酸、肌酐、空腹血糖水平的升高可加重冠状动脉病变范围;病变范围越广,心脏结构改变越明显,心室收缩功能受损越重,此情况在女性冠心病患者更为明显。

Objective To investigate the clinical features in different coronary artery disease and to provide more thorough evidences for preventing and treating coronary heart disease （CHD）. Methods 404 patients undergoing coronary angiography were divided into four groups： no-vessel lesion（ n = 124） ,single vessel lesion in = 102）, double vessel lesion （ n = 91 ）, three vessel lesion （ n = 87 ）. The general condition, related biochemical indexes, heart structure and function were compared. Results The patients age,the incidence of hypertension, diabetes mellitus and old myocardial infarction were higher as coronary arterial disease （CAD） count increased ;some biochemistry labels such as the plasma levels of glucose, urinary acid and creatinine were also higher; the size of left atrium became enlarged and cardiac function degraded. Inparticular,the changes were renarkoble in female patiens. Conclusion The extent of CAD is associated with the patients age, the histories of hypertension,diabetes mellitus,the plasma levels of glucose, urinary acid and creatinine also influence coronary artery disease counts ; the more of coronary artery disease counts, the worse of heart structure and functions, especially in the group of female.