58例不稳定型心绞痛的临床特征与预后

目的 :探讨不稳定型心绞痛 ( U A)患者的临床特征与心电图改变的预后价值。方法 :随机选取 5 8例 UA患者进行临床与心电图随诊 ,观察高危因素与预后的关系。随诊 1～ 4年 ,平均随诊 17个月。结果 :5 8例 UA患者中 ,有心绞痛史40例 ( 6 9.0 % ) ,入院时心绞痛 47例 ( 81.0 % ) ,顽固性心绞痛 12例 ( 2 0 .7% ) ,心绞痛发作时 ST段改变 46例 ( 79.3% ) ,发生急性心肌梗死 ( AMI)和心源性猝死 ( SCD) 12例 ( 2 0 .7% )。经四格表 χ2检验显示顽固性心绞痛与 U A患者的不良预后有显著相关性 ( P<0 .0 2 5 )。结论 :U A患者的心绞痛严重程度与发作频率以及心电图 ST段改变 ,对 UA患者发生 AMI或 SCD有良好的预报价值。

Clinical character and prognosis of 58 patients with unstable angina pectoris

Objective: It is to investigate the clinical character and prognostic value of electrocardiogram (ECG) change of unstable angina pectoris (UA). Methods: Fifty-eight patients with UA were randomly chosen to follow up clinic and ECG. The relation between high-risk factors and prognosis were observed for from one to four years. The average time was 17 months. Results: Forty patients (69.0%) had histories of previous angina. Forty-seven patients (81.0%) had angina at admission. Twelve patients (20.7%) had stubborn angina. Forty-six patients (79.3%) had ST-segment changes on ECG at angina recurrence. Twelve patients (20.7%) had acute myocardial infarction and sudden cardiac death. Stubborn angina and adverse prognosis of UA had significant relation by fourfold table chi-square test assay (P<0.025). Conclusion: The serious degree and recurrent frequency of angina and ST-segment changes on ECG have good predictable value on occurring acute myocardial infarction or sudden cardiac death of UA patients.