冠心病患者冠状动脉侧支循环影响因素探讨

目的:探讨冠心病患者冠状动脉侧支循环形成的意义及影响侧支循环形成的相关因素。方法:选择冠状动脉闭塞病变的患者298例,根据冠状动脉影结果分为两组:有侧支循环组(n=148)和无侧支循环组(n=150)。用单因素和多因素回归分析方法分析了患者年龄、性别、高血压病史、糖尿病史、吸烟史、饮酒史、血脂、以及冠状动脉管炎病变特点、闭塞程度与侧支循环的关系。结果:与无侧支循环组相比,有侧支循环组患者中多支冠状动脉闭塞率及完全闭塞率明显增高(分别为39.2%比10.7%,P<0.01;85.8%比28.0%,P<0.01)。Logistic多元逐步回归分析也证实:闭塞血管数及闭塞程度与侧支循环形成间存在有意义的回归关系。结论:侧支循环多出现在病变严重的冠心病患者,冠状动脉病变严重程度是冠状动脉侧支循环形成的决定性因素。

Influential factors of coronary collateral circulation in patients with coronary heart disease

Objective:To investigate the significance of coronary collateral circulation in patients with coronary artery disease(CAD)and factors influencing collateral channel development. Methods:298 patients with coronary artery occlusion who underwent coronary angiography were divided into 2 groups:the forming colateral circulation group(n=148)and controlgroup(the no colateral circulation group)(n=150).Coronary angiograms were accessed.Collateral circulation was graded according to contina scoring system.Clinical characteristics were analyed.Results:The multiple vessel occlusion rate and complete occlusion rate of coronary artery were significantly higher in the forming colateral circulation group than those in the no collaterai circuation group.Multivariate logistic regression analysis showed that vassel occlusion number and degree were two significant variables associated with collateral circulation.Conclution :The coronary collateral circulation is found mainly in patients with severe coronary artery diseases.The serious degree of coronary occlusion lesion is plays a key role in coronary colateral circulation.