冠状动脉侧支循环与冠心病相关因素的分析

目的探讨冠状动脉侧支循环与冠心病(CHD)相关因素的关系。方法将197例选择性冠状动脉造影(SCA)结果的SCA患者分为正常对照组(非CHD组)31例、CHD无侧支循环组136例、CHD有侧支循环组30例,分析各组患者的临床资料。结果与非CHD组相比,CHD组男性发病明显多于女性,合并高血压、糖尿病者明显增高(P<0.05);与CHD无侧支组相比,CHD有侧支组病变以3支、多支及次全闭塞为主(P<0.05),右冠脉病变最多;无侧支组以单支、前降支病变为主。糖尿病、吸烟、血脂异常、不稳定心绞痛、心功能不全、室壁瘤、心肌梗死、左主干病变的发生两组无明显差异(P>0.05)。结论冠状动脉侧支循环与CHD合并3支、多支病变及次全闭塞密切相关。

Correlative analysis of collateral circulation of coronary artery and coronary heart disease

Objective To study the correlative factors between collateral circulation of coronary artery and coronary heart disease(CHD).Methods 197 cases undergoing selective coronary arteriography were divided into control group(noncoronary heart disease,n=31),CHD with collateral circulation group(n=136),and CHD without collateral circulation group(n=30).The clinical data and result were analyzed comparatively.Results In comparison with control group,there were higher ratio of male patients and more hypertension and diabetes patients in CHD groups,(P<0.05).In CHD without collateral circulation group,the lesion was found mainly in anterior descending artery.In CHD with collateral circulation group,the lesion generally involved in 3 or more branches and the major pathological lesion was subtotal occlusion and the right coronary artery was more vulnerable to insult(P<0.05).There were no significant differences in terms of the incidence of diabetes,smoking,abnormal blood-lipid,unstable angina pectoris, cardiac insufficiency,ventricular aneurysm,myocardial infarction,and left branch lesions between the two CHD groups.Conclusion The establishment of collateral circulation of the coronary arteries is closely correlated with 3 or more branch lesions and subtotal occlusion of coronary arteries.