Page A, Conri C, Sicart M, Broustet J P, Besse P
Arch Mal Coeur Vaiss. 1978 Oct;71(10):1099-106.
We have studied the fate of 49 patients with stenosis of the trunk of the left coronary artery of more than 50%. The follow-up period extends from 1,5 years to 5 years (with a mean of 33.83 +/- 13.55 months). The clinical picture was not characteristic. Unstable angina was found in 59% of cases. The exercice test (29 patients) was positive in 100%, with a mean depression of 3.3 mm. Stenosis of the trunk, which is rarely an isolated condition (8% of cases), is usually associated with disorders of the other main coronary vessels. Twenty six patients underwent surgery. Thirteen patients who were operable were treated medically. The performance of the left ventricle and the degree of involvement of the coronary arteries were comparable in these two groups. Seven inoperable patients were treated medically. Actuarial survival curves show a significant difference (p less than 0.01) in survival after two years between the operated cases (88%), the operable cases treated medically (60%), and the inoperable cases (57%). The decreased mortality of the operated cases corresponds also with a greater functional capacity in the survivors compared with that of the cases treated medically.
我们研究了49例左冠状动脉主干狭窄超过50%的患者的预后情况。随访期从1.5年至5年（平均为33.83±13.55个月）。临床表现无特异性。59%的病例出现不稳定型心绞痛。运动试验（29例患者）阳性率为100%，平均压低3.3毫米。冠状动脉主干狭窄很少为孤立情况（8%的病例），通常与其他主要冠状动脉病变相关。26例患者接受了手术。13例可手术的患者接受了药物治疗。这两组患者的左心室功能和冠状动脉受累程度相当。7例不可手术的患者接受了药物治疗。精算生存曲线显示，术后两年，手术病例（88%）、可手术但接受药物治疗的病例（60%）和不可手术病例（57%）的生存率存在显著差异（p<0.01）。手术病例死亡率的降低也与幸存者相比接受药物治疗的病例具有更大的功能能力相对应。
