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目的:总结单纯左冠状动脉主干(左主干)病变患者的临床特点、治疗及近期预后。方法:经冠状动脉造影或(及)介入治疗术明确为单纯左主干病变的12例患者,回顾性分析患者的住院资料。结果:①12例患者均有不同程度冠心病传统危险因素;②冠状动脉造影证实左主干狭窄>70%8例,左主干闭塞1例,左主干狭窄50~70%3例;③12例患者心电图Ⅱ、Ⅲ、aVF导联ST段压低8例,aVR、aVL导联ST段均抬高1例,单纯aVR导联ST段抬高2例,QRS间期延长1例,电轴相对左偏4例,V2~4导联ST段压低8例,V2~6导联ST段压低1例(其中左主干闭塞患者Ⅱ、Ⅲ、aVF、V2~4导联ST段压低且合并左前分支阻滞);④12例患者血浆脑钠肽水平明显升高;⑤3例冠状动脉介入治疗术、3例冠状动脉搭桥术均成功实施,12例患者住院期间均无心力衰竭、急性心肌梗死或再发心肌梗死、恶性心律失常(室性心动过速、心室颤动)、猝死或死亡等严重心血管事件发生。结论:单纯左主干病变患者多有≥2个冠心病传统危险因素,心电图改变及血浆脑钠肽水平升高为突出特点,冠状动脉介入治疗术、冠状动脉搭桥术及药物治疗是主要治疗手段,近期预后好。
Objective: To summarize the clinical features, treatment and prognosis of simple left main coronary artery (left main) lesion. Methods: Twelve patients, who were diagnosed as simple left main disease by coronary angiography or (or) interventional therapy, were retrospectively analyzed. Results ① All the 12 patients had traditional risk factors of coronary heart disease. ② Coronary angiography confirmed that left main stenosis was> 70% in 8 cases, left main occlusion in 1 case and left main stenosis in 50% ~ 70% in 3 cases. , ST segment depression in Ⅲ, aVF lead was 8 cases, STV in aVR and aVL lead were all elevated in 1 case, STV elevation in aVR lead was simple in 2 cases, QRS prolongation in 1 case, and left axis in 4 cases , ST segment depression in V2 ~ 4 lead was decreased in 8 cases, ST segment depression in V2 ~ 6 lead was in 1 case (Ⅱ, Ⅲ, aVF in left main occlusion, ST segment depression in V2 ~ 4 lead and left anterior branch block combined); ④12 cases of patients with plasma brain natriuretic peptide levels were significantly increased; ⑤ 3 cases of coronary intervention, 3 cases of coronary artery bypass surgery were successfully implemented, 12 patients were hospitalized without heart failure, acute myocardial infarction or recurrent myocardial infarction, malignant Arrhythmia (ventricular tachycardia, ventricular fibrillation), sudden death or death and other serious cardiovascular events. Conclusion: There are more than 2 traditional risk factors of coronary heart disease, electrocardiogram changes and plasma brain natriuretic peptide level in patients with simple left main disease. Among them, coronary artery interventional therapy, coronary artery bypass grafting and drug therapy are the main treatment measures. The recent prognosis is good.