36例变异型心绞痛患者动态心电图与冠状动脉造影对比分析

目的观察变异型心绞痛患者动态心电图改变与冠状动脉病变特点及相关性。方法对确诊变异型心绞痛36例的动态心电图和冠状动脉造影结果进行回顾性分析。结果 36例中有30例冠状动脉造影存在有意义的病变（狭窄≥50%）,占83%,其中中、重度狭窄（〉70%）共21例,占58%。单支病变所占比例高于多支病变,血管病变最多见于左前降支,其次为右冠状动脉。冠状动脉病变在70%以上的狭窄病例中,ST段抬高大于0.2 mV者15例,占42%;持续时间大于3 min者14例,占39%。结论变异型心绞痛更易于发生在有病变的冠状动脉,狭窄程度越重,冠状动脉痉挛发生率越高。冠状动脉痉挛时ST段抬高幅度及持续时间与冠状动脉病变严重程度密切相关。

Comparative analysis of dynamic dlectrocardiogram and coronary angiography in 36 patients with variant angina pectoris

Objective To explore the changes of dynamic electrocardiogram（DCG） and the characteristics of coronary artery lesion in patients with variant angina pectoris（VAP）,and further to investigate the possible relationship.Methods The examination results of DCG and coronary angiography（CAG） in 36 patients with VAP were retrospectively analyzed.Results There were 30 patients（83% of the total 36 patients） who had significant lesion of coronary artery（stenosis degree≥50%） shown in CAG.Of the 30 patients,21（58%） had medium to high stenosis（stenosis degree ＆gt; 70%）.The proportion of single vessel disease was higher than multiple-vessel.Vascular lesion was most often seen in left anterior descending coronary artery（LAD） followed by right coronary artery（RCA）.Among those 21 cases with stenosis ＆gt; 70%,ST segment elevation higher than 0.2 mV occurred in 15 cases（42%）,and ST segment elevating longer than 3 minutes occurred in 14 cases（39%）.Conclusion The patients with coronary artery disease tended to suffer from VAP.The stenosis was more severe,the coronary artery spasm was more frequent.The duration and elevation of ST segment positively correlated with the severity of the coronary artery disease during the coronary artery spasm.