航空航天医学杂志
航空航天醫學雜誌
항공항천의학잡지
AEROSPACE MEDICINE
2014年
5期
611-613
,共3页
胡秋玲%李晟琰%张莉%马葆琛
鬍鞦玲%李晟琰%張莉%馬葆琛
호추령%리성염%장리%마보침
Wellens综合征%不稳定心绞痛%左冠状动脉前降支T波综合症
Wellens綜閤徵%不穩定心絞痛%左冠狀動脈前降支T波綜閤癥
Wellens종합정%불은정심교통%좌관상동맥전강지T파종합증
Wellens syndrome%Unstable angina%The left anterior descending coronary artery T wave syndrome
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。
目的：觀察Wellens綜閤徵的臨床特點及診療常規。方法2008年1月～2012年12月收治的Wellens綜閤徵患者52例。平均隨訪10.20±13.22箇月，觀察其心絞痛髮作的特點、心電圖縯變的特點、超聲心動圖特點、心肌生化標記物水平、.冠脈造影特點及預後。結果①20例患者在一月內支架治療，3例擇期搭橋，29例未接受經皮冠脈介入治療（ PCI ）手術及冠狀動脈徬路移植術（ CABG ）手術治療的患者，其中6例隨訪期間接受PCI，7例（24.13％）進展為急性ST段抬高型心肌梗死，其中有1例（3.45％）髮生猝死；②心電圖T波縯變：其中36例心電呈偽善性改變，18例ST段輕度抬高，16例錶現為T波倒置或雙嚮。③超聲心動圖：28例記錄到室壁運動障。④心肌生化標記物水平：心肌肌鈣白升高者27例，6例肌鈣蛋白輕度增高。⑤52例冠脈病變均位于前降支近中段，35例患者前降支有側枝循環。結論對于Wellens綜閤徵，正確識彆心電圖，儘早介入或搭橋治療，患者可從中穫益。
목적：관찰Wellens종합정적림상특점급진료상규。방법2008년1월～2012년12월수치적Wellens종합정환자52례。평균수방10.20±13.22개월，관찰기심교통발작적특점、심전도연변적특점、초성심동도특점、심기생화표기물수평、.관맥조영특점급예후。결과①20례환자재일월내지가치료，3례택기탑교，29례미접수경피관맥개입치료（ PCI ）수술급관상동맥방로이식술（ CABG ）수술치료적환자，기중6례수방기간접수PCI，7례（24.13％）진전위급성ST단태고형심기경사，기중유1례（3.45％）발생졸사；②심전도T파연변：기중36례심전정위선성개변，18례ST단경도태고，16례표현위T파도치혹쌍향。③초성심동도：28례기록도실벽운동장。④심기생화표기물수평：심기기개백승고자27례，6례기개단백경도증고。⑤52례관맥병변균위우전강지근중단，35례환자전강지유측지순배。결론대우Wellens종합정，정학식별심전도，진조개입혹탑교치료，환자가종중획익。
Objective To explore the clinical features , Diagnosis and treatment and conventional of patients diag -nosed 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 a-cute 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 in 28.④Myocardial biochemical markers level The elevated cardiac troponin calcium white 27 cases;6 cases for troponin increased slightly.⑤The criminal coro-nary 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.
