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Study on the Relationship between Clinical Manifestation and Coronary Angiograms in Patients with Unstable Angina
Author(s): 
Pages: 370-373
Year: Issue:  4
Journal: ACTA UNIVERSITATIS MEDICINALIS NANJING

Keyword:  冠状动脉硬化性心脏病不稳定性心绞痛心电图Braunwald分级冠状动脉造影;
Abstract: 目的:分析不稳定性心绞痛(UA)患者临床表现与冠状动脉造影病变之间的关系,帮助临床对UA病人进行危险分层.方法:对UA患者153例进行Braunwald分级;在胸痛发作即刻、发作后6 h、12 h分别检测血浆心肌肌钙蛋白I或T(cTnI或cTnT);记录入院时、胸痛发作时、发作后12导联ECG(必要时18导联);所有患者均行冠脉造影证实为冠心病患者.结果:UA胸痛持续时间超过20 min者较低于20 min者3支病变率高(38.7%vs.20.5%,P<0.05);ECG有缺血性ST-T动态演变者左主干病变率高于ECG正常者(12%比0%,P<0.05).BraunwaldⅢ级患者中cTnI(T)阳性者3支病变率高于cTnI(T)阴性者(50.0%比17.1%,P<0.05).BraunwaldⅢ级3支病变率、C型病变率、复杂病变及冠脉腔内血栓(ICT)病变率分别高于Braunwald Ⅰ级(40.0%比14.6%;55.6%比12.5%;73.3%比31.3%;15.6%比2.1%;P<0.05),而A型病变率、简单病变率分别低于Braunwald Ⅰ级(13.3%比41.7%;10.2%比43.8%,P<0.05).结论:UA胸痛持续时间超过20 min者较低于20 min者3支病变率高;胸痛时ECG有缺血性ST-T动态演变者较ECG无改变者左主干病变率高.UA患者BraunwaldⅢ级冠脉病变范围广,复杂病变、ICT及C型病变率高,伴有cTnI(T)阳性者3支病变发生的危险性增加.
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