不稳定性心绞痛临床与冠状动脉造影分析

为了解不同类型不稳定性心绞痛的冠状动脉（冠脉）造影特点，对３８８例不稳定性心绞痛患者进行临床及冠脉造影对照分析。结果表明：初发劳力型心绞痛单支血管病变占６９．６４％，较其他各型多见（Ｐ＜０．０５）；静息型心绞痛三支血管病变和左主干病变较其他各型多见（Ｐ＜０．０５），复杂性病变和Ｃ型病变检出率也较其他各型高（Ｐ＜０．０５）；恶化劳力型心绞痛病变特征介于上述二者之间；梗塞后早期心绞痛“罪犯”病变多为次全闭塞或完全闭塞，较其他各型多见（Ｐ＜０．０５）；变异型心绞痛多半仅有轻度冠脉狭窄；梗塞后早期心绞痛血栓比初发、恶化型多见（Ｐ＜０．０５）。提示静息时心绞痛发作者病变更严重，应予积极治疗，对梗塞后早期心绞痛患者应加强抗凝治疗。

CORONARYANGIOGRAPHICCHARACTERISTICSOFPATIENTSWITHUNSTABLEANGINA

Inordertostudythecharacteristicsofcoronarylesionsofpatientswithunstableangina,coronaryangiogramsandclinicalmanifestationswereanalysedon388patients.Theresultswereasfol-lows:singlevesselediseasewasmorecommoninnewonsetefortangina(69.64%)thaninothergroups(P<0.05).Triplevesselediseaseandleftmaincoronaryarterylesionappearedmorefrequentlyinpa-tientswithrestanginathaninothergroups(72.34%and27.66%respectively,P<0.05),sodidcom-plexlesionsandtypeClesions(36.07%and60.64%respectively,P<0.05).Morethanhalfofthecul-pritlesionsinearlypostinfarctionanginawassubtotalortotalocclusions(53.12%),beingmorefre-quentlyfoundinthisthaninothergroups(P<0.05).MostofthepatientswithPrinzmetalvariantangi-nahadmildcoronarylesionsonly.Coronarythrombiwerefoundin10.45%ofthe388patients;theywerewasmorefrequentinpatientswithearlypostinfarctionangina(20.00%)thaninthegroupsofnewonsetefortangina,aggravatedefortanginaandPrinzmetalvariantangina(4.26%,7.53%and0%re-spectively,P<0.05).Coronarythrombiwerealsomorefrequentinthepatientswithchestpainatrest(16.39%)thaninthegroupsofnewonsetefortanginaandPrinzmetalvariantangina(P<0.05).Itissuggestedthatpatientswithanginaatrestshouldbetreatedmoreintensively.Strengthenedanticoagula-tiontreatmentshouldbegiventopatientswithearlypostinfarctionanginaandanginaatrest.