心脏X综合征诊疗的现状

Present status of cardiac X-syndrome in diagnosis and therapy

目的 :冠脉造影可准确地诊断出心脏X综合征。该征也有心绞痛的表现 ,但其预后与冠脉狭窄引起的心绞痛迥然不同。为提高对本征的认识 ,本文主要阐述心脏X综合征的临床特点、发病机制、诊断及治疗。方法 :复习了近 3年来的有关文献和新出版的专著 ,全面地综合了有关心脏X综合征的资料 ,进行系统归纳整理。结果 :传统的认识本征的特征是冠脉造影正常。然而 ,根据冠脉内超声及多普勒检查发现 ,X综合征病人也有冠脉粥样硬化存在 ,大多数为局灶性、偏心性改变。只是斑块所致狭窄的程度为 6%～ 5 0 %。另有研究表明 ,心脏X综合征患者的缺血阈在夜间和清晨较低 ,高峰在下午出现 ,呈单峰分布。结论 :本征的心绞痛不同于冠脉狭窄所致的心绞痛。其治疗采用抗心绞痛药物疗效不恒定。需根据病人情况 ,酌情选用异搏定、氨酰心安、硝酸酯类或静滴氨茶硷等。

Objective:Cardiac X-syndrome could be diagnosed accurately by coronary angiography.This syndrome also had the clinical manifestation of angina,But its prognosis was quite different from that of angina caused by coronary stenosis.In order to improve the understanding on x-syndrome,We elaborated it's clinical characteristics.Mechanisms,diagnosis and thereapy as well.Methods:Late three years documents and newly published monographs concerned were reviewed.Also,data related with x-syndrome were summarized and arranged overall.Results:That coronary was traditionally regarded as the characteristic of x-syndrome.However,according to the findings by intracoronary ultrasonography and.Doppler ultrasound,coronarsclerosis also existed in patients with x-syndrome,mostly being local or eccentrie.Only the degree of stenosis caused by patch accounted for six-fify percent.Another study showed,the ischemia threshold in patients with x-syndrome was lower at night and early morning,while peak in afternoon,showing single-peak distribution.Conclusion:The Angina of x-syndrome was different from that resulted from coronary stenosis.Its curative effect was uncertain when anti-angina drug threapy was adopted.It need choose verapamil atenolol nitroglycerin or vein drop aminophylline. [