心电图正常的冠心病心绞痛患者冠状动脉造影特点

Coronary angiographic features in patients with coronary artery disease and normal resting electrocardiogram

目的:为了解静息心电图正常的冠心病心绞痛患者冠状动脉(冠脉)造影特点,以提高诊断水平。方法:对268例静息心电图正常的冠心病心绞痛患者的冠脉造影结果进行分析。结果:冠脉造影显示2～3支血管病变201例,占75.0％,单支血管病变58例,占21.6％。201例2～3支血管病变中173例(86.1％)血管狭窄部位相互对应。2支血管病变为前降支和右冠者多见,占47.0％(63/134),单支血管病变以前降支者多见,占46.6％(27/58)。82.8％(48/58)单支血管狭窄为50％～74％。单纯左主干病变2例。结论:冠心病心绞痛患者冠脉2～3支血管病变者心电图正常与血管狭窄部位相互对应有关,单支血管病变与狭窄程度较轻有关。对临床上心电图正常疑为冠心病的患者,应及早做冠脉造影检查以明确诊断。

Objective: To investigate the features of selected coronary artery angiography (SCA) of patients with coronary artery disease (CAD) and normal resting electrocardiogram (ECG). Methods: Two hundreds and sixty eight patients with angina pectoris and normal resting ECG were studied, their clinical data and results of SCA were analyzed. Results; Among all patients, 201 (75.0%) cases had lesions in more then 2 vessels, 58 cases (21. 6%) cases in single-vessel, and 2 cases in left main coronary artery. For those patients with more then 2 vessels disease, 86.1% (173/201) had lesions at the opposite side of each vessel. In 63 of 134 patients with 2 vessels disease, the lesions were found in LAD and RCA. For single-vessel disease patients, lesions were mainly found in LAD (27/58), and the stenosis were usually (48/58) mild to moderate (50%-74%). Conclusion: For patients with CAD and normal resting ECG, the majority have multi-vessel vessel, and the lesions are often found at the opposite side of each vessel.