CAJ | 학술논문

目的总结严重冠状动脉痉挛患者的临床特点,治疗方法及随访预后情况.方法选择确诊为冠状动脉痉挛的患者21例.了解患者的一般情况,包括年龄、性别、基础疾病、吸烟史及用药等,分析其临床特点、心电图、冠状动脉造影资料、诊断治疗及随访预后情况.结果严重冠状动脉痉挛患者以男性多见,占86％(18/21);吸烟是主要的危险因素,占62％(13/21);痉挛多发生于有固定狭窄的部位,占57％(12/21),临床经过凶险,及时冠状动脉造影对早期明确诊断至关重要.钙离子拮抗剂是有效治疗的核心,其使用强调持续、足量,介入治疗不是有效的方法.冠状动脉痉挛急性发作期具有极高的危险性,但长期预后良好.结论冠状动脉痉挛临床常见,但易被忽视,及时诊断是防止致命事件的关键,钙离子拮抗剂是冠状动脉痉挛的核心用药,远期预后良好.
목적 총결엄중관상동맥경련환자적림상특점,치료방법급수방예후정황.방법 선택학진위관상동맥경련적환자21례.료해환자적일반정황,포괄년령、성별、기출질병、흡연사급용약등,분석기림상특점、심전도、관상동맥조영자료、진단치료급수방예후정황.결과 엄중관상동맥경련환자이남성다견,점86％(18/21);흡연시주요적위험인소,점62％(13/21);경련다발생우유고정협착적부위,점57％(12/21),림상경과흉험,급시관상동맥조영대조기명학진단지관중요.개리자길항제시유효치료적핵심,기사용강조지속、족량,개입치료불시유효적방법.관상동맥경련급성발작기구유겁고적위험성,단장기예후량호.결론 관상동맥경련림상상견,단역피홀시,급시진단시방지치명사건적관건,개리자길항제시관상동맥경련적핵심용약,원기예후량호.
Objective To summarize the clinical features,treatment and follow-up of patients with severe coronary artery spasm.Methods Twenty-one patients with confirmed coronary artery spasm were selected.The study reviewed the patients' general conditions including age,gender,complication,smoking and drug situations.The clinical features,electrocardiogram and coronary angiography data were analyzed.Their diagnosis,treatment and prognosis were evaluated.Results Male (86％,18/21) had higher incidence in severe coronary artery spasm.Smoking (62％,13/21) was a major risk factor.Coronary artery spasm often happened on the base of a fixed narrow (57％,12/21),and the clinical process was treacherous.Coronary angiography was very important for early diagnosis.Calcium antagonist was the core of the treatments and should be sustained at full dose.Interventional therapy was not efficacious.Although patients in acute phase had higher risk,long-term prognosis was good.Conclusions Coronary artery spasm is a common problem,but it is often overlooked.Timely diagnosis is the key to prevent fatal events.Calcium antagonist is the core of the coronary artery spasm drugs.The long-term prognosis of coronary artery spasm is good.