Vedel J, Cahen C, Thomas D, Frank R, Grosgogeat Y
Nouv Presse Med. 1977 Nov 19;6(39):3629-30, 3635-7.
The indications of coronary arteriography have multiplied in recent years. Therapeutic indications have followed knowledge of the good results of revascularisation surgery. Initially limited to severe stable angina improved little or not at all by major anti-angina agents, they have been extended, in the view of many, to include various types of unstable angina where, in addition to the symptomatic improvement obtained, an attempt is made to decrease the incidence of myocardial infarction and of long term mortality. Indications relative to determination of the extent of disease may be preventive: the fear of severe coronary lesions on the basis of effort test results, the fear of a second infarction immediately following a primary lesion, or as a virtually routine examination in young individuals in order to better assess the degree of disease and to guide treatment. Diagnostic indication should be rare.
近年来,冠状动脉造影的适应证不断增加。治疗性适应证是随着对血运重建手术良好效果的认识而产生的。最初,其仅限于严重的稳定型心绞痛,这类患者使用主要的抗心绞痛药物后改善甚微或毫无改善,而现在,许多人认为其适应证已扩大到包括各种类型的不稳定型心绞痛,对于这类患者,除了获得症状改善外,还试图降低心肌梗死的发生率和长期死亡率。与确定疾病范围相关的适应证可能具有预防性质:基于运动试验结果对严重冠状动脉病变的担忧、对初次病变后立即发生第二次梗死的担忧,或者作为年轻人几乎常规的检查,以便更好地评估疾病程度并指导治疗。诊断性适应证应该很少见。