Buchalter M B, Been M, Williams D O, Adams P C, Reid D S
Department of Cardiology, University of Newcastle-upon-Tyne, England.
Jpn Heart J. 1992 May;33(3):295-302. doi: 10.1536/ihj.33.295.
The aim of this study was to assess whether the incidence of early occlusion following angioplasty was greater among patients with unstable angina and whether the coronary lesions prone to early occlusion could be predicted from their angiographic appearance. Seventy-seven patients who had had a first angioplasty of a native vessel for stable or unstable angina in one twelve month period were included. The angiographic appearances of the angioplastied lesions were classified as either Type 1, which were smooth and unlikely to have thrombus or intimal rupture, or Type 2, which were irregular due to thrombus or intimal rupture. The lesion classification was compared to the patients' clinical features, i.e. stable or unstable angina, and the outcome of the angioplasty. Type 2 lesions occurred in 25% of patients with stable angina but 49% of patients with unstable angina (p less than 0.05). Early sudden occlusion of the angioplastied vessel occurred in 24% of patients with unstable angina but in only 3% of patients with stable angina (p less than 0.05) and in 6% of Type 1 lesions compared with 24% of Type 2 lesions (p less than 0.05). Thus it is possible to identify the clinical characteristics and angiographic appearances of those patients undergoing angioplasty who are most likely to experience early vessel occlusion.
本研究的目的是评估血管成形术后早期闭塞的发生率在不稳定型心绞痛患者中是否更高，以及能否根据冠状动脉病变的血管造影表现预测易发生早期闭塞的病变。纳入了77例在12个月内首次对天然血管进行血管成形术治疗稳定型或不稳定型心绞痛的患者。血管成形术治疗病变的血管造影表现分为1型，即病变光滑，不太可能有血栓或内膜破裂；或2型，即病变因血栓或内膜破裂而不规则。将病变分类与患者的临床特征（即稳定型或不稳定型心绞痛）以及血管成形术的结果进行比较。2型病变在稳定型心绞痛患者中占25%，但在不稳定型心绞痛患者中占49%（p<0.05）。血管成形术治疗的血管早期突然闭塞在不稳定型心绞痛患者中占24%，但在稳定型心绞痛患者中仅占3%（p<0.05），在1型病变中占6%，而在2型病变中占24%（p<0.05）。因此，有可能识别出接受血管成形术的患者中最有可能发生早期血管闭塞的临床特征和血管造影表现。
