【摘要】 目的观察Wellens综合征的临床特点及诊疗常规。方法 2008年1月~2012年12月收治的Wellens综合征患者52例。平均随访10.20±13.22个月,观察其心绞痛发作的特点、心电图演变的特点、超声心动图特点、心肌生化标记物水平、.冠脉造影特点及预后。结果①20例患者在一月内支架治疗,3例择期搭桥,29例未接受经皮冠脉介入治疗(PCI)手术及冠状动脉旁路移植术(CABG)手术治疗的患者,其中6例随访期间接受PCI,7例(24.13%)进展为急性ST段抬高型心肌梗死,其中有1例(3.45%)发生猝死;②心电图T波演变:其中36例心电呈伪善性改变,18例ST段轻度抬高,16例表现为T波倒置或双向。③超声心动图:28例记录到室壁运动障。④心肌生化标记物水平:心肌肌钙白升高者27例,6例肌钙蛋白轻度增高。⑤52例冠脉病变均位于前降支近中段,35例患者前降支有侧枝循环。结论对于Wellens综合征,正确识别心电图,尽早介入或搭桥治疗,患者可从中获益。更多还原

【Abstract】 Objective To explore the clinical features,Diagnosis and treatment and conventional of patients diagnosed Wellens syndrome. Methods 52 patients with Wellens syndrome. from January 2008 to Deceber 2012 were Our hospital,The average follow-up 10. 20 ± 13. 22 months,and all of them had the consecutive The characteristics of heart attacks,The characteristics of electrocardiogram( ECG) evolution and ultrasonic cardiogram( UCG) characteristics and Myocardial biochemical markers level,and Coronary angiography characteristic and outcome. Results ①Heart attacks time More than 20 minutes,The 20 cases had PCI in one month,3 cases had coronaryartery bypass grafting( CABG),and 29 cases without PCI or CABG,and 6 cases among them accepted PCI,7 cases( 24. 13%) developed into ST elevation acute myocardial infarction and one cases( 3. 45%) of them had sudden cardiac death. ②The cardiac troponin Tlevel: 36 cases of changes in ECG hypocrisy,18 patients with st-segment mild elevations,16 cases of performance for T wave the cart before the horse or two-way,and,From heart attacks are not synchronizedand Many appear in angina pectoris ease after several hours or days. ③UCG dyskinesia of the left ventricle were found in28. ④Myocardial biochemical markers level The elevated cardiac troponin calcium white 27 cases; 6 cases for troponin increased slightly. ⑤The criminal coronary artery in 52 cases located in the proximal and middle of the LAD( 100%),with stenosis > 90% in 8 cases,70% ~ 90% stenosis in 36 cases,and 50% ~ 70% stenosis in 6 cases,and 30% ~ 50% stenosis in 2 cases,and < 30% stenosis in 0 cases,there were 35 cases had collateral circulation to LAD. Conclusions A profound understanding of Wellens syndrome,acutePCI or CABG,Patients can benefit from it.更多还原