95例拟诊冠心病心绞痛患者冠状动脉造影分析

Correlation between clinical features of angina and coronary artery angiography in 95 patients suspected coronary artery disease

目的:总结95例临床拟诊冠心病心绞痛患者的冠状动脉造影结果,分析其临床症状及其心电图ST-T改变与冠状动脉造影确诊冠心病的相关性。方法:从发作性胸痛、胸闷为主诉或伴心电图ST-T改变的患者中,筛选出符合或疑似心绞痛,并经心脏超声、胸片检查排除了其他心脏病患者95例,其中典型心绞痛36例;疑似心绞痛的非典型胸痛59例;伴有ST-T改变者87例(缺血型改变25例、非特异性改变62例)。分别接受选择性冠状动脉造影。血管内径狭窄≥50%为造影阳性,诊断冠心病的依据。结果:95例患者造影阳性的45例,其中36例典型心绞痛造影者阳性34例(伴ST-T典型缺血型改变23例、非特异性改变者10例、无改者1例),阳性率94.44%;59例非典型胸痛造影阳性11例(伴非特异性ST-T改变),阳性率18.64%。两组阳性率有显著差异(P<0.01)。结论:典型心绞痛患者冠脉造影诊断冠心病相关性高,非典型胸痛或心电图非特异性ST-T改变患者冠脉造影诊断冠心病阳性率低。

Objective：To summarize the correlation between clinical features of angina and coronary artery angiography（CAG）in 95 patients suspected coronary artery disease.Methods：The 95 patients with chest pain or abnormal ST-T were studied.In which 36 patients had typical angina,59 patients had atypical chest pain,87 patients accompanied by abnormal ST-T（25 patients with ischemic change,62 patients with unspecific change）.These patients were underwent selected coronary artery angiographies.when coronary artery stenosis was more than 50%,the results of CAG was positive.Results：Among 95 patients,45 patients had positive CAG.In 36 patients with typical angina（25 patients with ischemic ST-T change,10 patients with unspecific change and one patient with no change）,34 patients had positive CAG（94.44%）,its positive incidence was more than that of atypical chest pain（18.64%）,P〈0.01.Conclusion：The patients with typical angina are highler related to positive CAG,while the patients with atypical chest pain or unspecific abnormal ST-T are lower related to positive CAG.