冠脉造影正常心电图提示缺血改变患者的临床病因分析

目的 探讨心电图有缺血性改变(ST-T异常或有病理性Q波)的冠状动脉造影正常患者可能存在的病因及其发病机理.方法选择曾在我院住院,心电图有缺血性改变(ST-T异常或有病理性Q波),伴或不伴胸闷、胸痛临床症状而冠状动脉造影正常的患者608例(其中心电图ST-T异常526例,异常Q 波52例,同时有ST-T异常和异常Q 波30例,心电图异常伴胸闷、胸痛的446例).冠脉造影显示病变狭窄≥50%诊断为冠心病,＜50%定义为冠脉造影正常.结果 608例冠脉造影正常患者中,高血压365例、心血管神经症84例、X综合征41例、心瓣膜病26例,这些疾病为患者主要病因,患者心电图异常或出现胸闷、胸痛症状可能与上述疾病有关.结论高血压、心血管神经症、X综合征、心瓣膜病为心电图有缺血性改变,伴或不伴胸闷、胸痛临床症状而冠脉造影正常患者的主要病因,患者心电图异常或出现胸闷、胸痛症状可能与这些疾病有关.

Coronary angiography in the normal electrocardiogram prompted ischemic changes of the patient's clinical etiology analysis

Objective To explore the etiology and pathogenesis of ECG ischemic changes （ST-T abnormalities or pathologic Q wave） in patients with normal coronary angiography. Methods 608 patients who were approved ischemic alteration of ECG （ST-T alteration or pathological Q wave） but the coronary angiography were normal （There are 526 cases of ST-T abnormalities of ECG, 52 cases of abnormal Q waves, 30 cases of ST-T abnormalities and abnormal Q waves of ECG. 446 cases of ECG abnormalities with chest distress and pain） were enrolled. Coronary angiography showed stenosis I〉 50% for the diagnosis of coronary heart disease, 〈50% defined as normal coronary angiography. Results In 608 cases with normal coronary angiography, 365 cases were hypertension patients, 84 eases were cardiovascular neurosis patients, 41 cases were X syndrome patients and cardiac valvular disease were 26 cases. As the main etiology, patients with abnormal ECG or symptoms of chest distress and pain may be associated with these diseases. Conclusion Hypertension, cardiovascular neurosis X syndrome, valvular heart disease are major cause of ischemie ECG changes in patients with coronary angiography normal.