难治性心绞痛30例分析

Clinical Analysis of 30 Cases of Refractory Angina Pectoris

【目的】总结难治性心绞痛的临床特征,分析难治的原因,探讨治疗的经验和方法。【方法】回顾性对比分析难治性心绞痛(30例)与非难治性心绞痛(50例)两组患者的临床特征、药物治疗与近期预后的异同。【结果】与对照组相比,难治性心绞痛患者年龄大;陈旧心肌梗死、卒中、外周血管病患病率高;平均血红蛋白低[(107.93±21.7)vs(148.60±16.10)g/L,P<0.0001],血肌酐水平高[(139.59±73.58)vs(82.84±42.23)μmol/L,P=0.0005],左室射血分数低[(48.17±9.27)vs(57.98±48.17),P<0.0001]。冠状动脉造影左主干病变多(30.00%vs 6.00%,P=0.0097),多支病变多(93.33%vs 72.00%,P=0.0433)。院内病死率明显较高(23.33%vs 0%,P=0.0015)。【结论】难治性心绞痛患者平均血红蛋白低、血肌酐水平高、左室射血分数低;左主干病变、多支病变较多;预后较差,病死率高。

[Objective]To identify the clinical features and the outcome of patients with refractory angina. [Methods]The characteristics, management, and outcome were retrospectively compared between patients with refractory angina （group A, n = 30） and non-refractory angina （group B, n = 50）. [Results]Patients in group A were older and had higher proportion of prior myocardial infarction, stroke, peripheral vessel disease than those in group B. The level of creatine in group A was higher than that in group B[（139. 59±73.58） vs （82.84±42. 23） μmol/L, P=0. 0005],the concentration of hemoglobin and the left ventricular ejection fraction （LVEF） were significantly lower in group A than in group B[（107. 93±21.7） vs （148. 60±16. 10）g/L, P〈0. 0001 ; （48. 17±9.27） vs （57. 98±48. 17）, P〈0. 0001]. More patients in group A had Left main lesions and muhivessei lesions than those in group B（30. 00% vs 6.00% , P =0. 0097;93.33% vs 72.00%, P =0. 0433）. The in hospital mortality was higher in group A（23. 33% vs 0%, P = 0. 0015）. [Conclusion]Patients with refractory angina have higher serum creatine,iower hemoglobin concentration ,lower LVEF . The in hospital mortality of refractory angina is higher.