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目的 探讨风湿性心脏瓣膜病中冠状动脉粥样硬化的发生率及相关因素。方法 对 41例拟行心脏瓣膜置换术的风湿性心脏瓣膜病患者 ,术前常规行选择性冠状动脉造影检查及相关实验室检查。结果 141例风湿性心脏瓣膜病中 8例伴发不同程度的冠状动脉内径狭窄或完全闭塞 ,其冠状动脉粥样硬化的发生率为 19.5 % ;2 5 0岁以上风湿性心脏瓣膜病的冠状动脉粥样硬化发生率高于本组平均及 49岁以下年龄组发生率 ;3风湿性心脏瓣膜病合并冠状动脉粥样硬化的发生率 ,男∶女 =1∶ 1.7;4风湿性心脏瓣膜病合并冠状动脉粥样硬化的发生率与瓣膜病的种类及病变程度无明显相关性 (P>0 .0 5 ) ;5风湿性心脏瓣膜病心电图 ST- T缺血改变、房颤与冠状动脉粥样硬化的发生率无明显相关性 (P>0 .0 5 ) ;6风湿性心脏瓣膜病临床心绞痛、高血脂和心电图病理性 Q波与冠状动脉粥样硬化的发生率有相关性 (P<0 .0 5 )。结论 15 0岁以上风湿性心脏瓣膜病患者应常规在术前做选择性冠状动脉造影检查 ;2心绞痛、高血脂及心电图病理性 Q波是风湿性心脏瓣膜病合并冠状动脉粥样硬化的主要危险因素
Objective To investigate the incidence of coronary atherosclerosis in rheumatic heart valve disease and related factors. Methods Forty-one patients with rheumatic valvular heart disease who underwent heart valve replacement routinely underwent preoperative selective coronary angiography and related laboratory tests. Results Among the 141 patients with rheumatic valvular disease, 8 patients were complicated with varying degrees of stenosis or complete occlusion of coronary artery, and the incidence of coronary atherosclerosis was 19.5%. Coronary arteries of patients with rheumatic valvular heart disease The incidence of atherosclerosis was higher than the average in this group and the age group under 49 years; 3 the incidence of rheumatic valvular disease with coronary atherosclerosis, male: female = 1: 1.7; 4 rheumatic valvular disease complicated There was no significant correlation between the incidence of coronary atherosclerosis and the type and degree of valvular disease (P> 0.05); 5 rheumatic valvular heart disease ST-T ischemic changes, atrial fibrillation and coronary atherosclerosis There was no significant correlation between the incidence of sclerosis and the severity of coronary atherosclerosis (P> 0.05) .6 There was a significant correlation between clinical angina pectoris, hyperlipidemia and electrocardiographic pathological Q wave and the incidence of coronary atherosclerosis in rheumatic heart disease .0 5). Conclusions Patients with rheumatic valvular heart disease over the age of 15 should routinely undergo preoperative selective coronary angiography.2 Angina, hyperlipidemia, and electrocardiogram Pathological Q waves are a major risk of rheumatic valvular disease with coronary atherosclerosis factor