高危不稳定型心绞痛患者临床和冠状动脉造影特点

目的　研究高危不稳定型心绞痛 (U A)患者临床和冠状动脉造影特点。方法　 115例 U A患者根据其病史、心电图及肌钙蛋白 T(Tn T)变化分为低危险组 (A组 ,48例 )、中危险组 (B组 ,3 6例 )和高危险组 (C组 ,3 1例 )。分别记录入院前 48h心绞痛发作情况 ,其中 98例 (A、B、C组各 41例、3 0例和 2 7例 )进行了冠状动脉造影 ,详细分析冠状动脉病变情况 ,住院期间同时测定 C-反应蛋白 (CRP)水平。结果　 C组心绞痛病史明显短于 A组和 B组 ,二组比较差异均有显著性 (P<0 .0 1和 P<0 .0 5 ) ;C组患者入院前 48h心绞痛发作次数较 A组为多 (P<0 .0 5 ) ;C组三支病变较 A组多见 ,而单支病变 A组较 C组多见 (P均 <0 .0 5 ) ;C组 CRP水平较 A、B组明显增高 (P均 <0 .0 5 )。结论　高危险组冠状动脉病变较低、中危险组广泛 ,心绞痛发作次数亦较后二组为多 ,临床上常需要更强的药物治疗及积极的介入和外科治疗

Clinical features and angiographic findings in unstable angina patients with high risk

Objective To investigate the clinical features and angiographic findings in unstable angina(UA) patients with high risk. Methods According to the history, electrocardiogram changes and serum levels of troponin T(TnT),one hundred and fifteen patients with UA were classified into three groups: low risk(group A, n =48), intermediate risk(group B, n =36) and high risk(group C, n =31).The ischemic episodes within 48 hours before admission were carefully recorded through asking patients. C reactive protein(CRP) of all patients was measured while in hospital. Coronary angiography in 98 patients(41,30,27 in group A ,B and C respectively) was done at admission. Results The frequency of ischemic episodes within 48 hours before admission in group C was higher than that in group A ( P <0.05); The history of angina in group C was shorter than that in group A and B ( P <0.01 and P <0.05). Coronary triple vessel involvement was more frequent in group C than that in group A, and signal vessel involvement in group A was more frequent than that in group C( P <0.05). Serum CRP levels in group C was significantly higher than those in group A and B ( P <0.05, respectively). Conclusion Involved coronary in high risk group was more extensive than that in low and intermediate risk group, and the frequency of ischemic episodes in high risk group was higher than that in low and intermediate group too. So stress drug and positive interventional and surgical treatment should be performed.