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目的探讨影响慢性冠状动脉闭塞病变(CTO)多支病变侧支循环形成的因素。方法选择2003—2008年沈阳市第四人民医院心血管内科40例既往无心肌梗死的CTO患者,分为侧支良好组(A组)和侧支不良组(B组)。对两组患者的冠脉造影特点、临床特征进行对比分析。结果 A组中左优势冠脉即回旋支粗大占67.8%,B组中左优势冠脉仅占25.0%(P<0.05),A组近端病变患者明显多于B组(P<0.01),心绞痛病程(>3个月)在A组中占96.4%,在B组中占66.6%(P<0.05)。多因素logistic回归分揭示冠脉近端病变和糖尿病是良好侧支循环形成与否的独立影响因素。结论冠脉近端部位闭塞及左优势冠脉类型易于在CTO多支病变中建立侧支循环,心绞痛病程(>3个月)时侧支循环明显增多,冠脉近端病变和糖尿病是侧支循环形成的独立影响因素。
Objective To investigate the factors that affect the formation of collateral circulation in patients with chronic coronary artery occlusion (CTO). Methods Forty cases of CTO patients without previous myocardial infarction in the Fourth People ’s Hospital of Shenyang, from 2003 to 2008 were divided into two groups: control group (A group) and collateral dysfunction group (B group). Coronary angiography characteristics and clinical characteristics of two groups of patients were compared. Results In group A, the left superior coronary artery was 67.8% in the left circumflex artery, while the left superior coronary artery in the group B was only 25.0% (P <0.05). The number of proximal lesions in group A was significantly higher than that in group B (P <0.01) The duration of angina (> 3 months) was 96.4% in group A and 66.6% in group B (P <0.05). Multivariate logistic regression analysis revealed that coronary proximal lesions and diabetes were independent influencing factors for the formation of collateral circulation. Conclusions The occlusion of the proximal coronary artery and the left superior coronary artery tend to establish collateral circulation in the CTO multi-vessel disease. The collateral circulation is obviously increased during the course of angina pectoris (> 3 months). The coronary artery proximal lesion and diabetes mellitus are collaterals The formation of independent factors.