冠状动脉瘤样扩张与冠状动脉狭窄对心肌缺血影响的比较研究

目的研究冠状动脉瘤样扩张与冠状动脉狭窄对心肌缺血的影响。方法比较冠状动脉造影确诊的冠状动脉瘤样扩张(A组),冠状动脉瘤样扩张合并冠状动脉狭窄(B组)及冠状动脉狭窄(C组)3组间冠心病常见危险因素、病变血管分布、心肌缺血改变的差异。结果3组间冠心病常见危险因素差异无显著性;病变血管分布A组多累及右冠脉,B组、C组多累及左前降支,差异有显著性(P<0.05,P<0.01);心绞痛3组间差异无显著性;心肌梗死与心电图ST-T异常发生率,A组低于B组、C组(P<0.05,P<0.01);LVED值A组小于B组、C组,EF值A组高于B组、C组(P<0.01)。结论冠状动脉瘤样扩张对心肌缺血的影响较冠状动脉狭窄低,但并非无害。

Effects on myocardial ischemia between coronary artery aneurysm and coronary artery stenosis

Objective] To assess the effects on the myocardial ischemia of coronary artery aneurysm and coronary artery stenosis. Methods] The coronary risk factors, the involved vessels, the parameters of myocardial ischemia of three groups were analyzed: group A, 30 patients with coronary artery aneurysm only; group B, 32 patients with coronary artery aneurysm and coexisting significant coronary artery stenosis; group C, 60 patients with significant coronary artery stenosis but without coronary artery aneurysm. Results] No significant difference of coronary risk factors amony three groups were found. The right coronary artery was the vessel most frequently involved in group A, while the left anterior deccending most frequently affected in group B and group C (P <0.05, P <0.01). No significant difference of angina pector was existed among three groups , but the rate of myocardial infraction and the change of ST-T of electrogram in group A was lower than in group B and group C (P <0.05, P <0.01), the LVED of group A was lower than of group B and group C, while the EF was higher in group A than in group B and group C(P <0.01). Conclusion] The effects on the myocardial ischemia of coronary artery aneurysm is lower than of coronary artery stenosis, but not completely innocuous.