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主动脉冠状动脉搭桥术后一年多的非典型性和缺血性胸痛

[Atypical and ischemic chest pain more than a year after aortocoronary bypass].

作者信息

Hoffmann A, Grädel E, Hasse J, Pfisterer M, Burkart F, Burckhardt D

出版信息

Dtsch Med Wochenschr. 1983 Oct 21;108(42):1583-6. doi: 10.1055/s-2008-1069788.

Abstract

215 consecutive patients were followed up for more than a year (22 +/- 9 months) after aortocoronary bypass. Recurrence of ischaemic (anginal) and atypical chest pain was assessed: 54% of all patients were completely without pain postoperatively, 76% free of angina and 93% improved by at least one NYHA class. The frequency of severe atypical chest pain was similar pre- and postoperatively (11% and 13%, respectively), but nearly double that of postoperatively severe angina (13% vs 7%, P less than 0.05). Limiting atypical chest pains in patients with pre-operative atypical chest pain was much more frequent postoperatively than in patients who pre-operatively had only angina (30% vs 11%, P less than 0.005). These two patient groups did not differ with respect to age, sex, degree of vessels disease, exercise-induced ischaemia or number and patency of bypasses. Thus, exercise-limiting atypical chest pain can influence the surgical results in up to 30% of patients with pre-operative atypical chest pain (with or without typical angina).

摘要

215例接受主动脉冠状动脉搭桥手术的患者在术后接受了超过一年(22±9个月)的随访。评估了缺血性(心绞痛性)和非典型胸痛的复发情况:所有患者中54%术后完全无疼痛,76%无心绞痛,93%至少改善了一个纽约心脏协会(NYHA)分级。严重非典型胸痛的发生率在术前和术后相似(分别为11%和13%),但术后严重心绞痛的发生率几乎翻倍(13%对7%,P<0.05)。术前有非典型胸痛的患者术后限制非典型胸痛的情况比术前仅有心绞痛的患者更为频繁(30%对11%,P<0.005)。这两组患者在年龄、性别、血管疾病程度、运动诱发的缺血或搭桥的数量及通畅情况方面并无差异。因此,运动受限的非典型胸痛可影响高达30%术前有非典型胸痛(有或无典型心绞痛)患者的手术结果。

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