冠心病患者冠状动脉侧支循环形成的形态学特点分析

目的:分析国人冠状动脉侧支循环的形态学特点。方法:将265例冠心病病人的冠状动脉造影结果进行分析,按Levin的方法进行分类,并与之比较。结果:不同狭窄程度两组间侧支循环开放率差别有高度统计学意义(X2=14.43,P<0.001)。三支血管间侧支循环开放率差别均有统计学意义(X2=3.96,X2=4.28,P<0.05)。东、西方组冠状动脉各支病变的侧支分布的比较差别有高度统计学意义(右冠状动脉X2=9.68,P<0.01;左冠状动脉X2=41.73,P<0.001;左冠状动脉旋支X2=8.54,P<0.01。结论:冠状动脉侧支循环的形成与冠状动脉狭窄程度及病变血管有关。中国人的冠状动脉侧支循环具有独特性。

Morphological characters of coronary collateral circulation in coronary heart disease

Objective: To analyse the collateral pathways of coronary arteries in Chinese Methods: 265 patients with≥75 % luminal diameter stenosis involving at least one major coronary artery diagnosis drawn from 694 patients by selective coronary angiography were retrospectively analysed angiographic features from January 1997 to March 2002. Patients with valvular heart disease, congenital heart disease, cardiomyopathy, and pulmonary heart disease were excluded from the study. The extension and functional capacity of coronary collateral circulation were assessed according to the Cohen and Rentrop grading system of 0 to Ⅲ. Results: 8 collateral pathways for the right coronary artery, 8 for the anterior descending artery, and 5 for the circumflex artery were found. These collateral circulation pathways have been mapped. Compared with Levin's literature, there are statistic values in right coronary artery investigation group (X2= 9. 68, P < 0.01), left-anterior descending artery investigation group(X2 =41. 73, P <0.001) and left - circumflex artery investigation group(X2 = 8. 54 , P <0. 01). Conclusion: The formation of collateral circulation has something to do with the narrow degree in coronary artery and pathological blood vessels. The collateral circulation's distribution in Chinese with obstructive coronary disease had significant difference from foreigners.