【摘要】 目的　了解变异型心绞痛 (VA)患者的冠状动脉造影表现 ,发作时冠脉血管痉挛的分布特点及与预后的关系。方法　对 4 5例有心电图记录心绞痛发作的VA患者进行分析 ,其中 37例进行了冠脉造影并随访出院后的心脏事件发生率。结果　① 37例冠造结果进行定量分析 ,Gensini评分≥ 4分者心脏事件发生率大于 <4分者 (P <0 .0 5 )。② 4 5例VA患者心绞痛发作时心电图显示冠脉痉挛部位中前降支 (LAD)和右冠脉 (RCA)痉挛的发生率多于其他冠脉 ,在LAD和RCA之间无明显差异 (49%vs 4 5 % )。有冠脉狭窄证据的VA患者 ,痉挛与狭窄的血管相对应。③ 37例行冠造者 ,狭窄和正常者各为 2 5、12例 (6 7.5 %vs 32 .5 % )。结论　变异型心绞痛可发生于有狭窄的冠脉或正常冠脉中 ,前者更多见。血管痉挛及病变部位多为LAD和RCA ,Gensini评分有助于判断预后更多还原

【Abstract】 Objective The study here reported was undertaken to research the demonstration of coronary arteriography in patients with variant angina,the distributive characteristics of coronary vasospasm and the prognostic value. Methods The electrocardiography of 45 patients with variant angina (VA)was analyzed during the episode of chest pain,37 of whose coronary arteriography was conducted and the incidences of heart event were recorded after discharging. Results ① The outcome of coronary arteriography was quantitatively analyzed in these 37 patients,as a result,the incidences of heart event with Gensini grading ≥ 4 were higher than those with Gensini grading < 4 (P< 0.05). ② In the study of the 45 patients,the coronary vasospasm involving the left anterior descending artery (LAD) 23 in (49%) and the right coronary artery (RCA) 21 (45%) was much more than the other coronary arteries,there was no difference between LAD and RCA. The coronary vasospasm and stenoses were correlated to each other in the patients with VA. ③ There were 25(67.5%)with coronary stenoses while the other 12 (32.5%)were normal in the 37 patients conducted with coronary arteriography . Conclusion Variant angina may develop in coronary vasospasm,or normal coronary artery,however,the former is more common. Coronary vasospasm and coronary stenoses are more common in LAD and RCA. Gensini grading is of great help for prognosis.更多还原