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[变异型心绞痛或伴有痉挛的固定性狭窄患者经皮冠状动脉腔内血管成形术的结果]

[Results of coronary transluminal angioplasty following Prinzmetal's angina or fixed stenosis with associated spasm].

作者信息

Cherrier F, Cuillière M, Danchin N, Ethévenot G

出版信息

Arch Mal Coeur Vaiss. 1984 Jul;77(7):800-5.

PMID:6236767
Abstract

Transluminal coronary angioplasty (TCA) was carried out in 130 patients (109 men and 21 women) with an average age of 51 years (range 20 to 76 years) between April 1980 and December 1982. The most commonly affected artery was the LAD (100). All patients were on heparin, coronary vasodilators and calcium antagonists before the procedure, and on calcium antagonists and platelet antiaggregant drugs after TCA. The material and methods used were those described by Gruntzig. In this population, we identified a group of patients, Group I, with fixed stenosis and associated coronary spasm--either Prinzmetal angina (13 cases, 6 of which had both ST-T elevation and other ECG changes) or spontaneous spasm with a variable degree of stenosis (2 cases). The stenosis remained greater than or equal to 70% in all cases after intracoronary injection of nitrate derivatives. There were no differences between this group and that of fixed stenosis (Group II) with respect to age and type of diseased vessel (although the right coronary artery was more commonly involved in cases of spasm). The overall primary success rate was 72.8% (14/15--93%--in Group I, and 85/121--70.2%--in Group II: no statistically significant difference). The angiographic relapse rate at 6 months was significantly higher in Group I (8/12: 67%) than in Group II (15/63: 23.8%) p less than 0.02. When "redilatation" with stable success is taken into consideration the difference is not significant (33% and 22.2% respectively). The relapses may be dissociated in Group I (2 cases with recurrent spastic angina and normal angiography).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1980年4月至1982年12月期间,对130例患者(109例男性和21例女性)进行了经腔冠状动脉血管成形术(TCA),平均年龄51岁(范围20至76岁)。最常受累的动脉是左前降支(LAD,100例)。所有患者在手术前均接受肝素、冠状动脉扩张剂和钙拮抗剂治疗,TCA术后接受钙拮抗剂和血小板抗聚集药物治疗。所用材料和方法为Gruntzig所描述的。在这一人群中,我们确定了一组患者,即第一组,患有固定性狭窄并伴有冠状动脉痉挛——要么是变异型心绞痛(13例,其中6例既有ST-T段抬高又有其他心电图改变),要么是伴有不同程度狭窄的自发性痉挛(2例)。冠状动脉内注射硝酸酯类衍生物后,所有病例的狭窄仍大于或等于70%。该组与固定性狭窄组(第二组)在年龄和病变血管类型方面无差异(尽管痉挛病例中右冠状动脉受累更常见)。总体主要成功率为72.8%(第一组14/15——93%,第二组85/121——70.2%:无统计学显著差异)。第一组6个月时的血管造影复发率(8/12:67%)显著高于第二组(15/63:23.8%),p<0.02。当考虑稳定成功的“再次扩张”时,差异不显著(分别为33%和22.2%)。第一组的复发可能不相关(2例复发性痉挛性心绞痛且血管造影正常)。(摘要截短于250字)

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