壁冠状动脉及其合并非严重冠状动脉粥样硬化患者的临床特征

Clinical features of simple tunnelled artery and that complicated with non-serious atherosclerosis

目的:探讨单纯性壁冠状动脉(TA)及其合并非严重冠状动脉粥样硬化狭窄(狭窄<70%)患者的特征及临床意义。方法:收集52例经冠状动脉造影证实的TA患者临床资料,剔除合并严重冠状动脉粥样硬化的患者,并根据造影结果将患者分为单纯性TA组(n=29)与TA合并非严重冠状动脉粥样硬化狭窄组(TA+AS组,n=21),统计分析两组心电图、临床表现和造影结果。结果:TA组患者中胸导联ST-T改变多见,TA+AS组肢体导联ST-T改变及严重临床事件多见。TA组中NobelⅡ级以上患者严重临床事件更为多见,而TA+AS组患者则无明显差异。严重临床事件多见于两组近中段TA患者,在TA组只发生于近中段TA患者,而在TA+AS组仅急性冠状动脉综合征多发生于近中段TA患者,稳定型心绞痛则随相应冠状动脉粥样硬化病变不同而异。结论:单纯性TA患者临床表现与TA部位及Nobel级别有关,而合并非严重冠状动脉粥样硬化时,严重临床事件发生增多。

Objective ： To investigate the clinical features of simple tunnelled artery （TA） and TA complicated with non-serious atherosclerosis （ lumen stenosis 〈 70% ） （ TA ＋ AS）. Methods ： We collected the clinical data of 52 patients with TA confirmed by selective coronary angiography, and divided them into a simple TA group （ n = 29 ） and a TA ＋ AS group （ n = 21 ） according to the results of angiography, excluding 2 cases of severe atherosclerosis. Results： Chest lead ST-T changes were common in the simple TA group, while limb lead ST-T changes and severe clinical events were obvious in the TA ＋ AS group. Severe clinical events were seen in patients above Nobel Ⅱ more in the former than in the latter, common in those with mesi-TA in both the two groups. Acute coronary syndrome was observed in patients with mesi-TA in the TA ＋ AS group, and stable angina varied with corresponding atherosclerosis. Conclusion ： The clinical manifestation of simple TA is related with its location and Nobel grade, and severe clinical events increase when TA is complicated by non-serious atherosclerosis.