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伴有长期冠状T波的心绞痛

[Angina with long-standing coronary T waves].

作者信息

Hamashige N, Doi Y, Odawara H, Yonezawa Y, Kuzume O, Chikamori T, Ozawa T

机构信息

Department of Medicine and Geriatrics, Kochi Medical School, Nankoku.

出版信息

J Cardiol. 1988 Sep;18(3):611-7.

PMID:3249280
Abstract

The clinical significance of long-standing (greater than or equal to 24 hours) coronary T waves without abnormal Q waves was evaluated in 24 patients with angina. They were categorized in two groups; 11 with ST elevation followed by coronary T waves (Group A), and 13 with coronary T waves alone (Group B). 1. The patients had long-standing or repetitive episodes of rest angina, with clinical features of unstable angina in all but one. Fifty-five % of patients in Group A and 85% in Group B had histories of effort angina. 2. Significant (greater than or equal to twice the upper normal) elevation of serum CPK value was observed in 36% of patients in Group A and in 46% in Group B. There was no correlation between the maximum CPK value and the number of leads with the coronary T wave. 3. Coronary angiography demonstrated significant (greater than 50%) coronary artery stenosis in 27% of patients in Group A and in 77% in Group B. The incidence of severe stenosis was greater in Group B than in Group A. Angioplasty was performed in 9% of patients in Group A and in 38% in Group B. 4. During the average follow-up period of 27 months, there was one cardiac event (unstable angina) in Group A, two events (one sudden death and one unstable angina) in Group B. Each cardiac event occurred after the patients themselves discontinued their medications. This was not related to the severity of coronary artery stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对24例心绞痛患者中持续存在(大于或等于24小时)且无异常Q波的冠状T波的临床意义进行了评估。他们被分为两组:11例伴有ST段抬高继以冠状T波(A组),13例仅有冠状T波(B组)。1. 患者有长期或反复的静息性心绞痛发作,除1例患者外均具有不稳定型心绞痛的临床特征。A组55%的患者和B组85%的患者有劳力性心绞痛病史。2. A组36%的患者和B组46%的患者观察到血清肌酸磷酸激酶(CPK)值显著升高(大于或等于正常上限的两倍)。CPK最大值与出现冠状T波的导联数之间无相关性。3. 冠状动脉造影显示,A组27%的患者和B组77%的患者有显著的(大于50%)冠状动脉狭窄。B组严重狭窄的发生率高于A组。A组9%的患者和B组38%的患者接受了血管成形术。4. 在平均27个月的随访期内,A组发生1次心脏事件(不稳定型心绞痛),B组发生2次事件(1例猝死和1例不稳定型心绞痛)。每次心脏事件均发生在患者自行停药之后。这与冠状动脉狭窄的严重程度无关。(摘要截短至250字)

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