不伴心肌梗死的冠状动脉完全闭塞病变心绞痛的临床分析

目的：探讨不伴心肌梗死的冠状动脉完全闭塞病变心绞痛患者的临床特点。方法：对24例不伴心肌梗死的冠状动脉完全闭塞患者的临床表现、心电图、超声心动图及冠状动脉造影资料进行回顾分析。结果：中、高危险组主要表现为静息心绞痛，低危险组和稳定性心绞痛组主要表现为劳力型心绞痛。冠状动脉造影显示左前降支闭塞10例（37％），右冠状动脉闭塞7例（26％），左回旋支闭塞6例（22％），合并多支血管病变23例（95．8％）。心电图ST段异常14例（58．3％）。62．5％的患者进行经皮冠脉血运重建术。结论：不伴心肌梗死的冠状动脉完全闭塞主要表现为劳力型心绞痛，心电图ST段异常是预测冠脉病变严重程度的主要危险因素。经皮冠状动脉介入治疗正成为慢性冠状动脉闭塞的主要手段之一。

The Clinical Character of Angina Pectoris with Coronary Total Occlusion without Myocardial Infarction

Objective: To observe the clinical characteristic of angina pectoris with coronary total occlusion without myocar-dial infarction. Methods: 24 patients of angina pectoris with coronary total occlusion without myocardial infarction were classi-fied into high ,moderate and low risk groups and stable angina group. The clinical situation ECG echocardiogram and coronary angiography were reviewed. Results: Moderate and high risk groups were mainly present as rest angina pectoris. low risk group and stable angina group were present as exertional angina. The coronary angiography showed 10 patients(37%)with left anterial descending artery occlusion ,7 patients(26%) with right coronary artery occlusion,6 patients(22%) with left circum-flex artery occlusion. 23 patients(95.8% ) with multi - vessels involved. ECG showed 14 patients(58. 3%) with abnormal ST segment. 62.5% of the patients received PTCA and stent treatment. Conclusion: Patients of angina pectoris with coronary to-tal occlusion without myocardial infarction were mainly present as exertional angina. Serious lesion can be identified by abnor-mal ST segment of ECG. PTCA is becoming the most common treatment of chronic coronary occlusion.