【摘要】 目的:探讨选择性冠状动脉造影对Ⅱ度以上房室传导阻滞(AVB)和病态窦房结综合征(SSS)老年患者病因诊断的临床意义。方法:将70例因缓慢性心律失常已安装永久起搏器的患者分为AVB组(28例)和SSS组(42例),分别行选择性冠状动脉造影,分析左前降支(LAD)、左旋支(LCx)、右冠状动脉(RCA)的病变,血管内径狭窄达50%以上者为造影结果阳性。结果:AVB组造影结果阳性者21例(75.0%),SSS组造影阳性者13例(31.0%),两组比较差异有非常显著性意义(P<0.01);同时AVB组病变血管主要是RCA(53.6%),SSS组主要是LAD(23.8%),两组RCA的累及率比较差异有显著性意义(P<0.05)。结论:冠心病为Ⅱ度以上AVB老年患者的主要病因,但并非SSS的主要病因。对Ⅱ度以上AVB的老年患者,需行冠状动脉造影检查,以进一步指导治疗。而对SSS的老年患者,不宜轻易诊断为冠心病而给予不必要的治疗。更多还原

【Abstract】 Objective: This study was designed to evaluate the incidence of coexistent coronary artery diseases(CAD) in patients with symptomatic bradyarrhythmias,including sick sinus syndrome(SSS) and atrioventricular block(AVB). Methods:Seventy patients implanted pacemaker due to SSS and AVB were performed coronary angiography for frequent attack of suspected angina. Results: The cornonay angiography(CAG) show the incidence of CAD was 75.0% and 31.0% in CAD patients and SSS patients,respectively.The right coronary artery(RCA) was more involved in patients with AVB than the ones with SSS(P<0.05). Conclusion:AVB was the consequence of coronary heart disease,while SSS was not.It was still careful of coronary angiography in the patients of SSS.更多还原