不稳定性心绞痛预后临床分析

Unstable angina pectoris prognosis clinical analysis

目的探讨不稳定性心绞痛患者远期预后的影响因素。方法采用回顾性分析总结我院2001—2007年间92例不稳定性心绞痛患者的临床资料，依据患者静息心电图，连续24h动态心电图，超声心动图及冠状动脉造影检查结果及患者的年龄、性别、吸烟、饮酒与否、室性心律失常的发生、危险度分层对远期预后的影响关系进行分析。结果左室射血分数（LVEF）低于45％的患者较高于45％的患者病死率高（P〈0．01），左冠状动脉主干病变的患者病死率远大于左前降支病变的患者（P〈0．01），年龄60岁以上的患者较60岁以下的患者病死率高（P〈0．05），女性患者较男性患者病死率高（P〈0．05），吸烟患者较不吸烟患者病死率高（P〈0．05），饮酒患者较不饮酒患者病死率无明显差异（P〉0．05），入院时心率大于90次／min的患者较心率小于90次／min的患者病死率高（P〈0．05），发生复杂型室性期前收缩患者病死率较无复杂型室性期前收缩患者病死率有明显意义（P〈0．01），高危组患者死亡率较低危组患者死亡率明显增加（P〈0．05）。结论左心室功能，冠状动脉病变部位和范围、年龄、性别、吸烟、复杂型心律失常、危险度分层均是影响不稳定性心绞痛的远期预后因素。

Objective Discussion influence unstable angina pectoris patients forward prognosis factor. Methods Uses the review analysis to summarize my courtyard during for 2001-2007 year 92 example unstable angina pectoris patients＇ clinical material,ceases activity the electrocardiogram based on the patients,the con- tinual 24 hours dynamic electrocardiograms,the echocardiogram and the coronary artery radiography inspection result and patients＇ age, the sex, smoking, drink wine or not, the room arrythmia occurrence, the risk factor lamination carry on the analysis to the forward prognosis influence relations. Results The left room shoots the menstruation number（LVEF） , Being lower than 45% the patient to compare higher than 45% The patient case fatality rate is high （P 〈 0.01 ） , the left coronary artery branch pathological change patient case fatality rate far is bigger than the patient who left front falls a pathological change （P 〈0.01 ） ,the age 60 year old of above patient compares 60 year old of following patient case fatality rates high （ P 〈 0. 05 ） , the feminine patient compares the masculine patient case fatality rate high （ P 〈 0.05 ） , the smoking patient to compare does not smoke the patient case fatality rate high （P 〈 0.05 ） , drinks wine the patient to compare does not drink wine the patient case fatality rate not obvious difference （ P 〉 0.05 ） , when in hospital the heart rate is bigger than 90 time/min the patient compares the heart rate to be smaller than 90 time /min patient case fatality rates high （ P 〈 0.05 ）. Has the complicated shape room the premature beat patient case fatality rate not to have the complicated shape room the premature beat patient case fatality rate to have the obvious significance （P 〈 0.01 ） , the high-risk group patient mortality rate low danger group patient mortality rate increases obviously （P 〈 0. 01 ）. Conclusion The left ventricle function, the coronary artery pathological change spot and the scope, the age, the sex, smoking, the complicated shape arrythmia,the risk factor lamination is affects the unstable angina pectoris the forward prognosis factor.