13例变异型心绞痛临床表现及心电图改变与冠脉造影对照分析.docVIP

13例变异型心绞痛临床表现及心电图改变与冠脉造影对照分析 　　[摘要] 目的 探讨变异型心绞痛患者临床表现及心电图改变与冠状动脉的关系。 方法 对13例确诊为变异型心绞痛的患者进行冠脉造影。以冠脉有无病变及病变情况与临床表现及心电图改变作对比分析。 结果 ①13例变异型心绞痛患者中，冠脉造影发现有狭窄性病变11例，未发现冠脉狭窄性病变2例。②心绞痛发作时，胸前导联ST-T改变与前降支病变符合率为82%；下壁ST-T改变与右冠脉病变符合率为50%。③13例患者心绞痛发作时，心律失常发生者6例，其中快速心律失常4例，缓慢性心律失常2例。 结论 变异型心绞痛是由于在冠脉狭窄或不狭窄的基础上发生血管痉挛，导致心肌缺血所致，如不及时治疗或治疗不当，极易发生猝死，可能是冠心病心源性猝死的原因之一，应予以充分重视。 　　[关键词] 变异型心绞痛；临床表现；心电图；冠脉造影 　　[中图分类号] R541 [文献标识码] B [文章编号] 1673-7210（2012）02（b）-0156-02 　　 　　13 cases aontrol analysis of clinical manifestation electrocardiogram changes and conronary angiography with variant angina 　　YANG Yiwei 　　Department of Cardiology, the First Hospital Affiliated to Chifeng College, Inner Mongolia Autonomous Region, Chifeng 024000, China 　　[Abstract] Objective To investigate the clinical manifestations and the relationship between electrocardiograph (ECG) changes and coronary artery in patients with variant angina. Methods 13 patients were diagnosed as variant angina by coronary angiography. Clinical manifestations and electrocardiogram changes according to the degree of coronary artery lesions (with or without lesion, or the situation of lesions) were analyzed. Results ① Of all the 13 patients with variant angina, stenosis lesions were found in 11 cases through coronary angiography, 2 cases were found with no coronary stenosis lesions. ② When angina attacked, the accordance rate of precardial lead ST-T changes and LAD lesions was 82%; the accordance rate of paries inferior ST-T changes and coronary artery lesions was 50%. ③ Of all the 13 patients, when angina attacked, arrhythmia happened to 6 cases of them, including 4 cases of tachycardia and 2 cases of slow arrhythmia. Conclusion Myocardial ischemia resulting from the occurrence of vasospasm based on coronary artery stenosis or not is the reason of variant angina. If doesn′t treat or treat not properly, it will lead to sudden death very easily. This may be one of the reasons of coronary heart disease sudden cardiacdeath (SCD), a