摘要
目的 分析孤立性回旋支病变的临床、介入治疗及预后特点。方法 6 3例确诊心绞痛或心肌梗死的患者为本院 2 0 0 0年 1月至 2 0 0 2年 12月收入院 ,并接受冠状动脉造影及介入治疗的病例。其中心肌梗死 36例 ,最小年龄 37岁 ,最大年龄 74岁 ,平均年龄 (5 7± 11)岁 ,男性 5 5例 ,女性 8例。 5 3例患者完成随访。结果 (1)冠脉及左心室造影 :6 3例患者共有 6 7处明显狭窄病变 ,近段狭窄 14处 ,中段狭窄 36处 ,远段狭窄 7处 ,钝缘支狭窄 10处 ,其中 11处狭窄为完全闭塞 ,15处狭窄为次全闭塞 (95 %～ 99% )。左心室功能正常者 34例 (5 4 % ) ,异常者 2 9例(46 % ) ,但平均EF正常 (71%± 12 % )。 (2 )心电图特征 :在回旋支病变所导致的Q波或非Q波心肌梗死患者中 ,病理性Q波及ST T异常最常出现在下后壁及下壁。在下后壁、前侧壁及高侧壁梗死患者中 ,以回旋支中段狭窄或闭塞最常见。 (3)介入治疗 :6 3例患者均成功置入支架 ,B型病变 (74 % )明显多于A、C型病变。平均支架直径 (3.12±0 .4 2 )mm ,平均支架长度 (15 .8± 4 .14 )mm。住院期间无并发症发生。 (4)随访 :随访时间 12～ 35个月 ,平均随访(2 0 .8± 5 .0 )个月。造影随访 6例均无再狭窄。 1例猝死 (1.9% ) ,2例发生非致死性心肌梗死 ,3例术后心绞?
Objective To analyse the clinical features and intervention therapy of isolated left circumflex artery disease. Methods Sixty three patients with angina pectoris or myocardial infarction had been subjected to coronary angiographic and intervention study. Their ages ranged from 37 to 74 years (mean 57±11 years). There were 55 men and 8 women. Fifty three cases were followed up. Statistical analysis was performed using SAS software methods for small samples. Results (1) In the 63 patients there were 67 distinct circumflex stenoses, of which, 14 were in proximal circumflex, 36 in middle segment, 10 in obtuse marginal branch and 7 in distal circumflex; 11 were total occlusion and 15 were subtotal occlusion (95% 99%). Left ventricular function was normal in 34 patients and abnormal in 29 patients, but the mean left ventricular ejection fraction was normal(71±12%). (2) Q wave and ST T wave abnormalities occurred most frequently at inferior and posterior walls and correlated with the disease of middle segment of circumflex. (3) Stents were implanted successfully in all patients. Type B lesions (74%) were more than type A and type C. Mean stent diameter and length were 3.12±0.42 mm and 15.8±4.14 mm respectively. During hospitalization there were no major complications. (4) During the mean follow up time of 20 months (range 12 to 35), there were one death (1.9%), 2 nonfatal AMI (3.8%) and 3 recurrent angina pectoris (5.7%). The incidence of major adverse cardiac events was 11.3%. The cumulative survival rate was 100% in 12 months. Conclusion The diagnosis of isolated left circumflex coronary artery disease by coronary angiogram was reliable. The successful rate of intervention therapy was high and long term prognosis was satisfactory for these patients.
出处
《中华老年多器官疾病杂志》
2004年第4期265-267,共3页
Chinese Journal of Multiple Organ Diseases in the Elderly
