走过性心绞痛发病机制及临床特征探究.docVIP

走过性心绞痛发病机制及临床特征探究 　　[摘要] 目的 探讨走过性心绞痛的发病机制和临床特征。方法 整群选取该院心内科自2013年6月―2016年6月间收治的冠心病心绞痛患者438例作为研究对象，所有患者均详细记录心绞痛发作情况，并经心脏冠脉造影进行检查，将确诊为走过性心绞痛的患者于其他心绞痛患者临床特征、心电图变化进行比较。结果 走过性心绞痛发病率为5.48%，临床漏诊、误诊率高达83.33%；患者静息心电图检查大部分患者未出现典型的缺血性ST水平压低改变；冠状动脉造影检查有13例为冠状动脉单侧支发生病变，8例为双侧支病变，有3例为三支病变，所有24例WTA患者均形成明显的侧支循环，14例采用经皮冠状动脉介入治疗，5例采用冠状动脉旁路移植术进行治疗，其余5例患者使用药物进行保守治疗，经治疗后所有患者均痊愈出院。结论 走过性心绞痛患者在活动开始前会表现心绞痛症状，随着活动的继续症状减轻或消失，静息心电图不表现典型的缺血性变化，容易造成漏诊和误诊，此类患者冠状动脉狭窄程度重，形成特别明显的动脉侧支循环，大部分患者需要经过血运重建得到治疗 [关键词] 冠心病心绞痛；走过性心绞痛；冠状动脉造影；发病机制；临床特征 [中图分类号] R541.4 [文献标识码] A [文章编号] 1674-0742（2017）01（a）-0100-03 [Abstract] Objective Explore the pathogenesis and clinical features of the walk-through angina. Methods Group selection Cardiology in our hospital from June 2014 to June 2016 patients with angina pectoris treated 438 cases of the study， all patients were documented cases of angina pectoris， and examined by coronary angiography， it will be confirmed through patients with angina pectoris in patients with other clinical characteristics， ECG changes were compared. Results Through sex incidence of angina pectors was 5.48% Traveled angina clinical misdiagnosis rate of up to 83.33%； patients with resting ECG No patient experienced a typical ischemic ST depression level changes； coronary angiography in 13 patients with unilateral lesions in the coronary artery branch， 8 cases of bilateral vessel disease， three cases of three-vessel disease， all patients were 24 cases WTA formed obvious collateral circulation， 14 cases of percutaneous coronary intervention， five cases of coronary artery bypass grafting for treatment， The remaining five patients using drugs conservative treatment， after treatment all patients were cured. Conclusion Traveled angina patients before the event will show symptoms of angina， with the continued activity of the symptoms reduce or disappear， resting ECG does not show typical ischemic changes easily lead to misdiagnosis and missed diagnosis， such patients severe coronary artery sten