Bertrand E, Renambot J, Chauvet J, Seka R, Ticolat R, Odi Assamoi M, Ndori R, Ekra A
Hôpital Nord, Marseille.
Arch Mal Coeur Vaiss. 1993 Apr;86(4):415-9.
The authors studied 31 cases of coronary artery disease with normal or minimally diseases coronary arteries in black Africans, 29.8% of 104 coronary patients undergoing coronary angiography in this series. These 31 cases comprised 16 cases of infarction, 10 cases of angina, 3 ventricular aneurysms and 2 cases of silent ischemia in diabetic patients. Twenty-five patients were men (80.6%). There were 6 women (19.3%) two of whom presented in the post-partum period. The average age of these patients was 45 years (males: 47.7 years; females: 41.8 years). The following risk factors were noted: smoking (60%), hypertension (25.8%), obesity (29%), diabetes (12.9%), serum cholesterol (average 2.15 g/l), serum triglycerides (average 1.25 g/l). The risk index per patient was 1.29. In comparison with coronary patients with angiographic coronary lesions (n = 73), the patients with normal angiography were significantly younger, comprised more females and had fewer risk factors (especially hypertension and diabetes), though this was not statistically significant. The prevalence of inaugural infarction was 81.2% in the cases of infarction with normal coronary arteries. These infarcts may be complicated by ventricular aneurysm formation. Spontaneous spasm was observed in 3 out of 31 patients (9.6%) at coronary angiography. A provocative test was performed in only 2 cases and 1 was positive. This deserves further study and may have therapeutic implications. The authors emphasise the high incidence of hemoglobin S or C traits (57.1%). These heterozygotic hemoglobinopathies could be a risk factor in these coronary patients with normal coronary angiography.
作者研究了31例冠状动脉疾病患者，这些患者为非洲黑人，其冠状动脉正常或仅有轻微病变，占该系列104例接受冠状动脉造影的冠心病患者的29.8%。这31例患者包括16例梗死患者、10例心绞痛患者、3例室壁瘤患者以及2例糖尿病无症状性心肌缺血患者。25例为男性（80.6%）。有6例女性（19.3%），其中2例在产后发病。这些患者的平均年龄为45岁（男性：47.7岁；女性：41.8岁）。记录到以下危险因素：吸烟（60%）、高血压（25.8%）、肥胖（29%）、糖尿病（12.9%）、血清胆固醇（平均2.15g/L）、血清甘油三酯（平均1.25g/L）。每位患者的风险指数为1.29。与冠状动脉造影显示有冠状动脉病变的冠心病患者（n = 73）相比，冠状动脉造影正常的患者明显更年轻，女性更多，危险因素更少（尤其是高血压和糖尿病），不过这在统计学上无显著差异。冠状动脉正常的梗死患者中首发梗死的患病率为81.2%。这些梗死可能并发室壁瘤形成。在31例患者中有3例（9.6%）在冠状动脉造影时观察到自发痉挛。仅对2例患者进行了激发试验，其中1例为阳性。这值得进一步研究，可能具有治疗意义。作者强调血红蛋白S或C性状的高发生率（57.1%）。这些杂合性血红蛋白病可能是这些冠状动脉造影正常的冠心病患者的一个危险因素。
