不同类型不稳定型心绞痛冠状动脉病变特点及其临床意义探讨

THE FEATURES OF CORONARY LESIONS IN DIFFERENT TYPES OF UNSTABLE ANGINA PECTORIS AND THEIR CLINICAL SIGNIFICANCE

目的 :观察不同类型不稳定型心绞痛冠状动脉病变的差异及其临床意义。方法 :选择 5 1例不稳定型心绞痛病人 ,入院时进行 Braunwald分级 ,并测定空腹静脉血血浆 GMP- 1 40和 D-二聚体含量 ,入院后 1周内行冠状动脉造影 ,分析其病变血管数及病变特点 ,同时进行狭窄程度评分。结果 :Braunwald 级不稳定型心绞痛患者三支血管病变及血管内血栓形成明显多于 、 级 (分别为 P<0 .0 1和 P<0 .0 5 ) ,狭窄评分 级也显著增高 ( P<0 .0 1 ) ,同时血浆 GMP- 1 40和 D-二聚体三级间也有显著性差异 (分别为 P<0 .0 1和 P<0 .0 5 )。结论 : 级不稳定型心绞痛病人常多支血管受累且冠脉内血栓形成多见 ,病情易变 ,应在病情稳定后积极行介入性治疗。

Objective:To observe the features of coronary lesions in different types of unstable angina pectoris(UAP) and their clinical significance.Methods:We performed coronary angiography on fifty one patients with different types of UAP within one week after admission.Plasma GMP 140 and D dimer were measured.The number of diseased vessels and the features of coronary lesions were analyzed,and stenosis scoring was performed.Results:The results showed that Buaunwald class Ⅲ UAP patients had higher rate of triple diseased vessels and coronary artery thrombosis than ones Ⅰ and Ⅱ ( P <0 05 and P <0 01 respectively).Stenosis score of class Ⅲ UAP patients was significant higher than that the other two classes ( P <0 01).There were significant differences among three classes in plasma GMP 140 and D dimer concentrations( P <0 05 and P <0 01 respectively).Conclusion:We conclude that class Ⅲ UAP patients have more multiple diseased vessels and more intracoronary artery thrombus than classes Ⅰ and Ⅱ.Their clinical feature is fragil.Active interventional treatment should be performed on these patients.