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目的:通过分析平板运动试验(TET)阳性而冠脉造影(CAG)阴性患者的临床特征,增强对TET阳性及其临床意义的认识,提高冠心病(CAD)的诊断准确率。方法:对我院近3年因胸痛住院患者进行TET检查,结果TET阳性而CAG阴性的100例患者临床特征进行回顾性分析。结果:TET阳性而CAG阴性的患者以女性多于男性;其中心脏自主神经功能紊乱占50%,高血压、肥厚型心肌病占28%,微血管性心绞痛(X综合症)占11%,冠状动脉肌桥占8%,先天性冠状动脉瘘占3%。结论:TET阳性且有典型心绞痛症状,但冠脉造影阴性的高血压患者,其发病机制应考虑为冠脉微血管病变所致;而心绞痛症状不典型者、或仅以ST-T改变的女性患者,若不伴或极少伴有CAD危险因素,临床诊断CAD更应慎重。
Objective: To improve the diagnostic accuracy of coronary heart disease (CAD) by analyzing the clinical features of patients with TET positive and coronary angiography (CAG) negative and improving the positive TET and its clinical significance. Methods: A retrospective analysis was performed on the clinical features of 100 patients with TET-positive and CAG-negative patients who underwent TET examination in our hospital for nearly 3 years. Results: TET-positive and CAG-negative patients had more women than men; 50% had autonomic dysfunction of the heart, hypertension, hypertrophic cardiomyopathy accounted for 28%, microvascular angina (syndrome X) 11%, coronary artery Myocardial bridge accounted for 8%, congenital coronary artery fistula accounted for 3%. CONCLUSIONS: TET-positive patients with typical angina pectoris but hypertensive patients with negative coronary angiography should be considered for coronary microangiopathy. Patients with atypical angina or ST-T only If not accompanied by or with minimal risk factors for CAD, clinical diagnosis of CAD should be cautious.