中老年心律失常与冠状动脉病变关系的探讨

A Study of the Relationship Between Cardiac Arrhythmia and Coronary Artery Disease in Middle-Aged and Older Patients

为了解不明原因的心律失常与冠状动脉病变的关系，对48例平均年龄52±4．6（40～68）岁拟诊冠心病的心律失常患者行冠状动脉造影。48例中22例为无典型心绞痛和心电图缺血改变的心律失常患者（A组），冠状动脉造影阳性率13．6％（3／22）；26例为有典型心绞痛和心电图缺血改变的心律失常患者（B组），冠状动脉造影阳性率92．3％（24／26）。两组比较，P＜0．001。48例中未绝经的8例患者冠状动脉造影均无异常，而绝经期后的9例中7．例冠状动脉有病变。提示对中老年不明原因的心律失常患者，尤其是绝期前的女性诊断冠心病宜慎重。

In order to explore the relationship between cardiac arrhythmias of unknown cause and coronary arterydisease,coronary angiography were per formed in forty-eight patients with cardiac arrhythmias.The results showedthat only 13. 6 % of twenty-two patients of cardiac arrhythmia companied with atypical chest pain and no myocardial ischemia in the ECG had coronary artery significant stenosis,but 92.3% of twenty-six patients of cardiac ar-rhythmia company with typical chest pain and myocardial ischemia in the ECG had coronary artery significantstenosis (P<0.001). The results indicate that the typical chest pain and myocardial ischemia for diagnosis as coro-nary heart disease clinically are more important than cardiac arrhythmias.