冠状动脉侧支循环某些相关因素的临床研究

目的研究冠状动脉侧支循环在冠状动脉完全闭塞与次全闭塞血管病变中的形成情况,观察心肌梗死病史、心肌肥厚及糖尿病对侧支循环形成的影响以及侧支循环对心肌的保护作用。方法回顾分析了我院一年内409例经冠状动脉造影证实的冠状动脉完全或次全闭塞患者,先按有无心肌梗死病史将患者分为两组,对照分析侧支循环形成的良好率,及心功能相关因素方面的差异。再按有无心肌肥厚、有无糖尿病病史分别分为两组,观察其对侧支循环形成的影响。结果冠状动脉完全与次全闭塞对比侧支循环形成的良好率有显著差异。有心肌梗死与无心肌梗死病史两组侧支循环形成的良好率比较无显著差异。两组的左心室舒张末期内径、左心室射血分数、室壁运动异常发生率及室壁瘤形成均有显著差异。而有心肌梗死病史者侧支循环良好组与不良组比较左心室舒张末期内径、左心室射血分数无差异。有无心肌肥厚对侧支循环形成良好率无差异。有糖尿病史者侧支循环血流良好率明显高于无糖尿病史者,且有显著差异。结论冠状动脉侧支循环的开放依赖于冠状动脉血管的完全或次全闭塞。冠状动脉缓慢闭塞下形成的侧支循环对心肌、心功能有保护作用。糖尿病有利于侧支循环的发展。     

颈动脉粥样硬化与不同类型冠心病的相关性分析

目的 了解冠心病患者颈动脉粥样硬化的发病率;分析冠心病患者颈动脉粥样硬化的相关危险因素;探讨冠心病患者颈动脉粥样硬化程度与冠状动脉粥样硬化程度的关系;总结不同类型冠心病患者颈动脉粥样硬化病理特点.方法 回顾性分析了228例经冠状动脉造影确诊为冠心病的病例冠状动脉造影结果 、颈动脉超声检测结果 及相关危险因素;根据颈动脉...     

颈动脉粥样硬化与不同类型冠心病的相关性分析

目的 探讨冠心病病人颈动脉粥样硬化程度与冠状动脉粥样硬化(CAAS)程度的关系及相关危险因素;总结不同类型冠心病患者颈动脉粥样硬化(CAS)病理特点.方法 回顾性分析228例经冠状动脉动脉造影确诊为冠心病的病例冠状动脉造影结果、颈动脉超声检测结果及相关危险因素;根据颈动脉是否有粥样硬化分为粥样硬化组及非粥样硬化组;根据WHO诊断标准将病例分为稳定型心绞痛组、不稳定型心绞痛组及心肌梗死组;根据冠状动脉造影结果将病例分为单支病变组(组A)、双支病变组(组B)、三支病变组(组C)及左主干组(组D);对颈动脉粥样硬化(CAS)程度进行积分处理.结果 发现228例冠心病病人中198例均有不同程度颈动脉粥样硬化,发病率86.8%;颈动脉粥样硬化(CAS)与高血压显著相关,与年龄、性别、体重指数、吸烟、嗜酒、高脂血症、高尿酸血症及糖尿病无明显相关;颈动脉粥样硬化(CAS)程度随冠状动脉粥样硬化(CAAS)的程度加重而加重,但仅仅一支病变组总斑块数显著低于左主干组(P＜0.05);稳定型心绞痛组的颈动脉等级积分、Crouse积分均低于不稳定型心绞痛组;稳定型心绞痛组颈动脉等级积分(grading integral)较急性心肌梗死组低,而Crouse积分高于急性心肌梗死组;稳定型心绞痛组的总斑块数、扁平斑数及软斑数均低于不稳定型心绞痛组及急性心肌梗死组,三组的硬斑数差异无统计学意义(P＞0.05).三组均未发现溃疡斑.结论 颈动脉粥样硬化与冠心病有相关性.

Abstract：

Objective To determine the relationship between the aggravation of CAAS and coronary atherosclerosis (CAS) ;and to summarize the pathologic character of CAAS of the patients with various coronary artery disease. Methods Review the result of coronary angiography and carotid artery ultrasonography and the related risk factors of the patients who were diagnosed as CAD through coronary angiography ( CAG). The patients were divided into the scleratheroma group and the non scleratheroma group. The patients were divided into stable angina pectoris( AP) group, unstable angina pectoris(UAP) group and acute myocardial infarction (AMI) group according to the criterion of coronary artery disease of WHO. The patients were divided into group A (coronary artery of single vessel lession) ,group B( coronary artery of double vessel lession ) , group C( coronary artery of triple vessel lession )and group D(left main vessel lession ).The aggravation of CAAS was graded. Results There were 198 patients with various CAAS among 228 patients with coronary artery disease ( 86. 8%). CAAS was much related with hypertension and non-related with age, sex, BMI, smoking, drinking, hyperlipoidemia, hyperuricosuria and diabetes mellitus. The aggravation of CAAS much graver with much graver CAS. But only the plaque number of Group A was more than Group D( P ＜0. 05). The grading integral and Crouse integral of CAAS of AP group was not remarkable less than UAP group. The grading integral of CAAS of AP group was less than AMI group and the Crouse integral of AP group was more. But there was no remarkable difference. The number of all plaque,plaque and plaque of AP group was not remarkable less than UAP group and AMI group. There was the plaque among the three group. Conclusion Carotid artery atherosclerosis (CAAS) is relative to coronary artery disease ( CAD).