摘要
为了评估成年人瓣膜病变患者的冠心病伴发率。我们对本院自１９８８年６月至１９９５年１２月４０岁以上５５０例瓣膜病患者的冠状动脉造影进行回顾性研究。男３４３例，女２０７例。年龄４０～７２岁，平均５４．３岁。二尖瓣、主动脉瓣和联合瓣膜损害分别为２０５例，１０７例，２３８例。１５６例心电图呈ＳＴ－Ｔ改变，１１６例有心绞痛症状。结果：５５０例中７６例冠状动脉有单支或多支≥５０％的狭窄病变，占１３．８％。就年龄组而言，４０～４９岁组合并冠心病５例（５／５７例，８．８％）；５０～５９岁组有５２例（５２／４０６例，１２．８％），６０～６９岁组有１８例（１８／８６例，２０．９％）和７０岁以上１例（１／１）。二尖瓣或（和）主动脉瓣见瓣膜钙化占５１．４％。７６例中有１１４支冠状动脉受累，前降支、右冠、回旋支、左主干依次为４６（４０．４％）、４１（３６．０％）、２５（２１．９％）和２（１．８％）支。１５６例心电图示ＳＴ－Ｔ改变中仅１３例合并冠心病。７６例心绞痛病史患者中仅１６例有冠状动脉病变并存。我们认为，（１）４０岁以上成年人瓣膜病患者的冠心病发生率为１３．８％；（２）瓣膜病患者临床心绞痛病史和心电图ＳＴ－Ｔ改变与有否合并冠心病?
To evaluate the incidence of coronary artery disease in adult patients with valvular disease in China, cine coronary arteriographic findings in 550 consecutive adult patients (aged over 40 years) with valvular disease from June 1988 to December 1995 was studied retrospectively. There were 343 males, 207 females with a mean age of 54.3 (range 40 72) years. Mitral, aortic and combined valvular diseases were in 107, 205 and 238 respectively. The ECG presented ST T changes in 156 cases. Seventy six patients complained angina pectoris. Seventy six of 550 (13.8%) cases including 64 males, 12 females had at least one vessel lesion. Coronary artery disease was found in 5 patients in 40 49 years group (8.8%), in 52 patients in 50 59 years group (12.8%) and 19 patients in 60 69 years group (22.1%), and one patient in >70 years group. Among the 76 patients, 34 cases had isolated mitral valve disease, 14 cases had isolated aortic valve disease and 28 cases had combined mitral and aortic valve disease. In all 76 patients, 114 vessels were involved including LAD, RCA, LCX and LMCA in 46 (40.4%), 41 (36.0%), 25 (21.9%) and 2 (1.8%) respectively. Single, double and triple (including LMCA) vessel disease were found in 52 (68.4%), 11 (14.5%), and 13(17.1%) respectively. In the 156 cases with ECG ST T changes, 13 had coronary artery disease. In the 76 cases with complaint of angina pectoris, only 16 of them had coronary artery disease. It is concluded that :(1) The incidence of coronary artery disease in adult patients above 40 years old with valve heart diease was 13.8%. (2) The incidence of coronary artery disease increased with age. (3) The presence of angina of ECG ST-T change did not predict associated coronary artery disease. (4) It is necessary to do coronary arteriography for adult patients above 50 years old with valvular heart disease before surgical therapy.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
1997年第5期337-339,共3页
Chinese Journal of Cardiology
