冠状动脉完全闭塞伴侧支循环建立52例的临床特征相关分析

Relative analysis on clinical characteristics from 52 cases of the collateral circulation establishment with total coronary occlusion

目的分析侧支循环建立患者的临床资料,寻求影响其形成的因素和临床特征。方法回顾性收集北京大学第三医院2005-09-01—2007-08-31第一次行冠状动脉造影记录,经冠状动脉造影确诊有1根冠状动脉完全闭塞,有侧支循环建立的住院病例52例,将无侧支循环建立病例52例作为对照组,分析其临床资料。结果使用Logistic回归分析患者一般临床资料、既往病史、生活习惯、目前服用药物与侧支循环建立的关系,与侧支循环建立相关的为既往患有糖尿病病史以及运动、饮酒,回归系数分别为0.408、0.483、0.197(P<0.05)。对其中不稳定心绞痛患者进行分析,心电图提示心肌缺血占28.6%,超声心动图提示室壁运动减弱占16.7%,运动平板试验阳性者占100%,负荷核素心肌显像提示灌注缺损占100%。结论侧支循环的建立与糖尿病、饮酒、运动相关,有侧支循环建立患者行心电图、超声心动图的阳性率低。

Objective To find out the factors which influence the establishment of collateral circulation as well as its clinical characteristics by analyzing the sufferers＇ medical records. Methods Review and collect the records of the first coronary angiography, and we can find the total occlusion of one coronary after coronary angiography. There are 52 cases in which people who suffered the establishment of collateral circulation stay in hospital for treatment. Here ,we take 52 cases in which people didn＇t suffer into comparison and analyze these clinical records. Results Use the Logistic regression method to analyze the relationship between general clinical data, past history, habits, current medication and the establishment of collateral circulation,which relates to the diabetes mellitus anamnesis, exercise and drinking habits, with the regression coefficient is 0. 408,0. 483,0. 197 （P 〈 0. 05 ）. Take the patient of unstable angina for example, ECG presents that the myocardial anemia accounts for 28.6%, echocardiography shows that the ventricle movement decline accounts for 16.7% ,the people who are positive in exercise treadmill test account for 100%. Conclusion The establishment of collateral circulation is related to diabetes mellitus, drinking and exercise. Patients with collateral circulation have low positive rate in ECG and echocardiography.