变异性心绞痛58例临床研究

目的 了解变异性心绞痛临床特点.方法 观察心绞艰发作时心电图变化.其中42例做冠状动脉造影,其中男性46例,女性12例,年龄29～68岁.凌晨熟睡时发作44例,午睡时发作14例.结果 发作时ST段伴T波高尖26例占44.8%,仅ST段抬高22例占37.9%,仅有T波高尖10例占17.2%.42例冠状动脉造影结果:冠状动脉狭窄≥70%有27例,侵犯1支8例占19.0%,侵犯双支19例占45.2%;冠状动脉狭窄<50%7例占16.8%;正常8例占19.0%.随访12～18个月,因药物不能理想控制心绞痛发作行PTCA 25例占43.1%,2例作了CABG,猝死1例,其余30例占57.7%,经药物治疗后症状消失.结论 变异性心绞痛主要是在冠状动脉狭窄基础上冠状动脉痉挛引起,夜间发作者可能为交感神经张力增高致冠状动脉痉挛.

A clinical study of prinzmetal's variant angina pectoris(58 cases)

58 cases including 46 men and 12 women of Prinzmetal's Variant angina pectoris were reported. 44 patients of angina attacked into deep sleep at midnight, 14 patient at afternoon sleepwell. EKG showed:ST segment elevation and tall peaked T wave had 26 cases(4. 8%);ST segmen elevation had 22(37. 9%) cases; Tall peaked T Wave had 10(17. 2%) cases. 42 cases with coronary angiopraphy showed:coronary artery stenosis was over 70%. 8(19. 0%) cases were sigle vessel disease; 19(45. 2%) cases were double vessel diseases. 7(16. 8%) cases with Coronary artery stenosis as lower 50%. 8(19. 0%) cases of coronary atrary were normal. Flollowed up for 12-18 months,25(43.1%) patients were selected PTCA. 2 patients were poerated with CABG. One sudden death occurred. 30(57. 7%) cases of chest pain had disappeared after drug therapy.