心电图ST-T改变冠状动脉造影正常者心肌活检分析

Myocardial Biopsies Analysis in Patients With Abnormal STT but Normal Coronary Angiography

目的：探讨心电图ＳＴ－Ｔ改变冠状动脉正常者的心肌病理改变。方法：静息持续或负荷心电图ＳＴ－Ｔ改变而冠状动脉造影正常的３２例患者取右心室心肌活检分析。结果：高血压、糖尿病、肥厚型心肌病的１１例患者心肌病理与临床诊断一致。临床上没有以上３种病及心脏瓣膜病、电解质紊乱、洋地黄影响的２１例患者中（含心律失常６例），有程度不等的心肌病变１０例，微血管病变６例，心肌炎４例及代谢障碍１例。结论：临床上不明原因的ＳＴ－Ｔ改变者，不一定是微血管病变的Ｘ综合征，有必要进一步心肌活检明确诊断。

? Objective:To study myocardial changes in patients with STT depression but normal coronary angiography. Methods:Right ventricular myocardial biopsies were performed in 32 patients with abnormal STT on rest or stress ECG despite the coronary artery was shown normal by angiography. Results:Myocardial biopsies in 11 patients with hypertension,diabetes mellitus,or hypercardiomyopathy showed a coincidence in pathologic changes.The pathologic manifestations in 21 patients with neither of above 3 kinds of disease and valvular heart disease,nor of electrolyte imbalance and digitalis treatment(included 6 cases with arrhythmia)showed cardiomyopathy in 10 cases,microvascular disorder in 6,myocardities in 4 and metabolic disorder in 1. Conclusion:Most patients of abnormal STT with unknown causes are probably not the Xsyndrome with microvascular disorder.It is neccessory to take myocardial biopsy for diagnosis.