心脏X综合征与心脏神经官能症的比较研究

目的　探讨心脏X综合征 (CSX)与心脏神经官能症 (CN)之间的差别。方法　对 5 7例CN患者和 2 5例CSX患者的临床资料和检查结果进行分析比较。结果　两组性别构成 ,合并高血压 ,糖尿病、冠心病家族史 ,吸烟的比例 ,年龄 ,BMI ,TG ,HDL -C ,UA和FIB之间无统计学差异 (P >0 0 5 ) ,但CSX患者的TC、LDL -C和apoB水平明显比CN患者高 (P <0 0 5 ) ,apoA1水平也有增高的趋势 (P =0 0 7)。CN患者的症状以不典型胸痛为主 ( 82 5 %) ,CSX患者则以典型性胸痛为主 ( 5 6 0 %) ,两组间差异显著 (P <0 0 1)。CSX患者运动试验的阳性率 ,心肌核素灌注显像的阳性率都比CN高 ,而两者的胸片、心脏超声、心电图异常比例无差别。结论　与CN患者比较 ,CSX患者存在血脂代谢的异常 ,这可能是其血管内皮功能紊乱的机制之一 ;对CSX患者进行调脂治疗可能有好处

A Comparison Study between Cardiac Syndrome X and Cardiac Neurosis

Objective To explore the similarity and difference between cardiac neurosis (CN) and cardiac syndrome X (CSX). Methods The clinical data of 57 patients with CN and 25 patients with CSX were retrospectively analyzed. Results There were no differences between the two groups in age, gender, smoking rate, the complications of primary hypertension or diabetes, BMI, TG, HDL-C, UA and Fib levels(P>0 05). The levels of TC, LDL-C and apoB in the patients with CSX were significantly higher than those in the patients with CN(P<0.05), and the concentration of apoA1 presented a increased trend in the former(P=0 07). The main symptom of the patients with CSX was typical chest pain (56%), while that of the patients with CN was atypical chest pain (82 5%). The patients with CSX had relatively higher positive rates of treadmill test or myocardial perfusion scintigraphy compared with the patients with CN. There were not significnat differences in abnormal chest film, electrocardiographic or echocardiographic changes between the two groups. Conclusion Compared with the patients with CN, it is more possible for the patients with CSX to suffer a disorder of lipid metabolism, which might contribute to the dysfunction of cardiovascular endothelia, and the patients with CSX may benifit from lipid-lowered therapy.