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中国内地冠状动脉血管痉挛相关的病例文献荟萃分析

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摘要:

目的 对我国冠状动脉血管痉挛(CAS)相关的病例进行统计和文献分析。方法 通过计算机以中文题名及关键词(“冠状动脉痉挛、冠脉痉挛、冠状动脉痉挛综合征、变异性心绞痛”)检索中国知网(CNKI)、万方数据库、维普(VIP)、中国生物医学文献数据库(CBM)数据库建库以来至2020年1月核心期刊公开发表的中文文献,纳入病例诊断为冠状动脉血管痉挛(冠脉痉挛)且数据资料完整的患者,分析疾病的临床特点以及血管内超声(IVUS)的应用等。结果 168篇文献197例病例纳入分析,冠脉痉挛患者平均年龄(50.57±13.44)岁,男性患者尤为突出(达79.6%);其中有72例冠脉痉挛患者痉挛发作有其他诱因,14例行冠脉内血管超声的CAS患者中其中冠脉造影检查提示正常冠脉的有3例(2例在IVUS观察下可见冠脉病变),其余11例冠脉造影下均有不同程度的冠脉狭窄;CAS患者冠脉正常组(90例)中心律失常的检出率为44.7%,与冠脉病变组(107例)心律失常检出率相比,差异具有显著性(P<0.05);197例CAS患者,7例死亡病例均出现在冠脉病变组,且与冠脉正常组差异具有统计学意义(P<0.05)。结论 CAS的发病机制及发病特点复杂且多样性,CAS患者冠脉病变组患者预后较差、更容易诱发心律失常,提示进一步应用先进的诊疗技术(IVUS)深入探索CAS的诊治及冠脉情况是必要的。

Abstract:

Objective To carry out a statistic and literature analysis on cases related to coronary vasospasm (CAS) in China. Methods The databases of CNKI, WanFang Data, VIP and CBM were retrieved from establishment time to Jan. 2020 for searching Chinese literature published on core journals by computer with Chinese title and keywords (coronary artery spasm, coronary artery spasm, coronary artery spasm syndrome, variant angina). The patients diagnosed as CAS with complete data and materials were included. The clinical characteristics of CAS and application of intravascular ultrasound (IVUS) were analyzed. Results There were totally 168 documents involved 197 cases included in the analysis. The average age of CAS patients was (50.57±13.44) years old and male patients accounted for 79.6%. There were 72 CAS patients with other inducement of CAS seizure. Among 14 CAS patients undergone coronary IVUS, 3 cases had indications of normal coronary artery (2 cases showed coronary artery lesions under IVUS observation), and other 11 cases undergone coronary angiography (CAG) had coronary stenosis in varying degrees. The detection rate of arrhythmia was 44.7% in normal coronary artery group (n=90) and had significant difference (P<0.05) compared with coronary artery lesion group (n=107). Among 197 CAS patients, 7 died cases were all in coronary artery lesion group, and difference had statistical significance compared with normal coronary artery group (P<0.05). Conclusion The pathogenesis and characteristics of CAS are complex and diverse. CAS patients with coronary artery lesions have poor prognoses and are more likely to have arrhythmia. It is suggested that application of IVUS further for deeply study CAS diagnosis and treatment and coronary artery conditions is necessary.

基金项目:

陕西省科学技术厅项目(2021JQ-787)

参考文献:

  • 2008

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