不稳定型心绞痛危险度分层和冠状动脉造影的关系

Relationship between clinical classification and coronary angiography findings in unstable angina pectoris

目的探讨不稳定型心绞痛危险度分层和冠状动脉病变的关系，观察能否通过不稳定型心绞痛危险度分层预测不稳定型心绞痛患者的冠状动脉病变程度。方法按照中华医学会心血管病学分会提出的不稳定型心绞痛危险度分层，将145例不稳定型心绞痛患者分为高、中、低三个危险组，比较三组间冠状动脉造影术显示的病变程度。采用Gensini积分方法，对各支冠状动脉病变程度进行定量评定，将其危险度分层赋予分值，低危险组1分，中危险组2分，高危险组3分，测定该分组和冠状动脉病变危险程度、冠状动脉完全闭塞病变及三支病变的关系。结果低、中、高三个危险组冠状动脉病变积分分别为30．43、39．10和68．05分，高危险组积分显著高于低、中危险组（P=0．000），而低、中危险组之间积分差异无统计学意义。不稳定型心绞痛危险度分组与冠状动脉病变程度显著相关。结论不稳定型心绞痛危险度分层和冠状动脉病变程度相关，可以作为冠状动脉完全闭塞病变和三支病变的预测因素。

Objective To study the relationship between clinical classification and coronary angiography findings in unstable angina pectoris. Methods 145 patients with unstable angina were divided into 3 groups according to the clinical classification standard proposed by the Cardiology Branch of Chinese Medical Association. The pathological changes among 3 groups and 21 cases with stable angina were compared and assessed by Gensini Intergral method. An unstable angina score from 1 to 3 determined by severe degree. 21 patients with stable angina were scored 0. Results The coronary lesion score in group 3 was higher than those in group land group 2, which were 68.05 vs 30.43 and 39.10 in average （P=0.000）. It was shown that the unstable angina score has significantly correlation with coronary lesion score. Conclusion The clinical classification of unstable angina correlates with the coronary lesion degree and can be served as a oredictor.