冠心病患者冠状动脉侧支循环形成的影响因素

为探讨冠状动脉侧支循环形成的影响因素 ,分析了 1 2 2例选择性冠状动脉造影 (冠状动脉造影 )证实有冠状动脉侧支循环形成的冠心病患者 (有侧支循环组 )及 1 31例至少有一支冠状动脉闭塞而无侧支循环形成的冠心病患者 (无侧支循环组 )的冠状动脉造影及临床资料。结果发现 :有侧支循环组 98.36 %的患者有一支冠状动脉完全闭塞或次全闭塞 ;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 30 .0 0 %比 1 1 .4 5 % ,P <0 .0 0 1 ;75 .77%比 6 0 .2 7% ,P <0 .0 5 )。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。此外 ,无侧支循环组患者血清总胆固醇水平及甘油三酯异常率较有侧支循环组明显增高 (5 .0 3± 1 .38mmol L比 4 .6 8± 1 .0 6mmol L ,P <0 .0 5 ;4 5 .80 %比 32 .78% ,P <0 .0 5 )。提示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 ,高脂血症不利于冠状动脉侧支循环的形成

An Analyse of the Influential Factors of Forming Coronary Collateral Circulation in Patients with Coronary Heart Disease

Aim To study the influential factors that lead to form coronary collateral circulation. Methods The date of coronary angiography and clinical characteristics were analysed in 253 cases with coronary heart disease(CHD) underwent coronary angiography coronary collateral circulation was present in 122 patients (Forming collateral circulation group) and absent in 131 patients as control group(No collateral circulation group). WTHZ]Results 98.36% of patients in the forming collateral circulation group presented complete or sub total occlusion of coronary artery . The multiple vessel occlusion rate and complete occlusion rate of coronary artery were significantly higher in the forming collateral circulation group than those of the no collaterai circulation group(30.00% vs 11.45%,p<0.001;75.77% vs 60.27%, p<0.05,individually). The rate of forming collateral was higher in the vessels with complete occlusion than those of sud total occlusion(58.09% vs 40.20%,p<0.05). Multivariate logistic regression analysis showed that vassel occlusion number and degree were two significant variables associated with collateral circulation.The level of serum total cholesterol and abnormal rate of serum triglycerin were significantly higher in the no collateral circulation group than those of the forming collateral circulation group (5.03±1.38 mmol/L vs 4.68± 1.06 mmol/L,p<0.05; 45.80% vs 32.78%,p<0.05). Conclusion The serious degree of coronary occlusion lesion is great important factors of whether forming coronary collateral circulation. Hyperlipidemia is not good for the formation of coronary collateral circulation.