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目的分析变异型心绞痛患者的动态心电图ST段变化特点及冠状动脉病变情况。方法对36例动态心电图显示ST段抬高型心绞痛患者进行冠状动脉造影检查冠状动脉病变情况。结果 36例变异型心纹痛发作时ST段呈多种形态上抬,最大ST段上抬约0.1～0.6mV,平均0.45mV,表现为斜上型、斜下型、水平型、弓背向上型、弓背向下型等形态,且不同时间不断演变。冠状动脉造影检查显示36例患者均有有意义的冠状动脉狭窄,其中中度狭窄14例(1支血管病变6例,2支血管病变8例),重度狭窄22例(2支血管病变14例,3支血管病变8例)。经对照比较发现冠状动脉狭窄程度与ST段上抬幅度并非一一对应关系。结论冠状动脉狭窄的基础上发生的痉挛可能是ST段抬高型心绞痛患者的发病基础,心纹痛发作时ST段形态不断演变,值得进一步研究。
Objective To analyze the characteristics of ST segment changes and coronary lesions in patients with variant angina. Methods Thirty-six patients with ST-segment elevation angina pectoris underwent coronary angiography in coronary artery disease. Results In the 36 patients with variant heart-shaped pain, the ST segment showed a variety of morphological uplifts. The maximum ST-segment elevation was about 0.1-0.6 mV with an average of 0.45 mV, showing obliquely upward, obliquely downward, horizontal, Type, bow back down and other forms, and evolving at different times. Coronary angiography showed significant coronary stenosis in all 36 patients, including 14 with moderate stenosis (6 with 1 vessel disease, 8 with 2 vessel disease), 22 with severe stenosis (14 with 2 vessel disease , 3 vascular lesions in 8 cases). The comparison found that the degree of coronary artery stenosis and ST segment elevation amplitude is not one to one correspondence. Conclusion The spasm based on coronary artery stenosis may be the basis for the onset of ST-segment elevation angina pectoris. ST-segment morphology evolves evidently during the onset of heart-stroke pain and warrants further study.