頁籤選單縮合
題名 | Variant Angina with Angiographically Normal or Near-normal Coronary Arteries : A 10-year Experience=變異型心絞痛併冠狀動脈攝影為正常或幾近正常 : 十年的經驗 |
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作者姓名(中文) | 劉秉昌; 鄭淇文; 洪明銳; 陳士仁; 楊甯貽; 郭李堂; 程文俊; | 書刊名 | 內科學誌 |
卷期 | 21:2 2010.04[民99.04] |
頁次 | 頁79-89 |
分類號 | 415.3161 |
關鍵詞 | Spasm; Variant angina; Inflammation; |
語文 | 英文(English) |
中文摘要 | 為探討變異型心絞痛病患其臨床和實驗檢查的特徵及其預後,我們篩選於本院執行心導管檢查的連續1,329 位急性冠心病病患,回溯分析變異型心絞痛病患併冠狀動脈攝影為正常或幾近正常之病歷記錄及冠狀動脈攝影資料。這十年來共14 位病患為變異型心絞痛病患併冠狀動脈攝影為正常或幾近正常。其平均年齡為52 歲;10 位為男性而其中9位有抽煙。除了一位病患外,大多數病患胸痛發生在半夜及早上。12 位在住院第二天早上有抽血者,其高敏感度C-反應蛋白質數據者其平均為5.5 mg/L 。心電圖均呈現一過性ST 波段升高,其中前壁導程有8位、下壁導程有3位、同時前及下壁導程有3位。這些病例中以左前降枝冠狀動脈痙攣最常見。於變異型心絞痛發生時,3位病患同時產生心房震顫,2位病患同時產生房室傳導阻滯。在中位數54 個月的追蹤中,無病患死亡、心肌梗塞、或復發變異型心絞痛。於追蹤期間有5 位病患因未戒煙或不規則服藥而有心絞痛發生。百分之一的急性冠心病病患為變異型心絞痛併冠狀動脈攝影為正常或幾近正常。變異型心絞痛併冠狀動脈攝影為正常或幾近正常佔ST 波段升高急性冠心病的2% 。這些病人的預後是好的。 |
英文摘要 | To determine clinical and laboratory characteristics and prognosis of consecutive Taiwanese patients presenting with variant angina and normal or near-normal coronary arteries. A total of 1,329 consecutive patients with acute coronary syndrome who underwent coronary angiography at out hospital were retrospectively screened and reviewed. Over a 10-year period at our hospital, variant angina developed in 14 patients who had normal or near-normal coronary arteries. Of the 14 patients included in the study, mean age 52 years, 10 patients were men and 9 of the 10 men were cigarette smokers. All but one patient developed chest pain between midnight and morning. Twelve patients whose blood tests for high-sensitivity C-reactive protein on the second day after admission had a mean level of 5.5 mg/L. The electrocardiographic location of transient ST-segment elevation was in the anterior leads in 8 patients, inferior leads in 3 and both anterior and inferior leads in 3. Spasm of left anterior descending artery was the most common finding in these cases. Three patients developed atrial fibrillation and 2 patients had atrioventricular block during variant angina. During a median follow-up period of 54 months, no patient expired, suffered a nonfatal infarction, or recurrent variant angina. One percent of patients with acute coronary syndrome had variant angina with normal or near-normal coronary arteries. The variant angina with normal or near-normal coronary arteries could be found in 2% of the patients with ST-segment elevation acute coronary syndrome. These patients had a good prognosis. |
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