冠状动脉造影大致正常的胸痛患者临床分析

摘要 目的：探讨有胸痛症状的冠状动脉造影大致正常的患者的临床特点及病因。方法：回顾性分析2019年1月至2021年5月我院收治的有胸痛症状疑诊为冠状动脉粥样硬化性心脏病并行冠状动脉造影的1283例患者，纳入其中冠状动脉造影提示冠状动脉大致正常的患者，比较冠状动脉造影结果大致正常者与冠状动脉造影存在异常的患者的人口学资料、危险因素等，并统计冠状动脉造影结果大致正常者的确定诊断并进行分析。结果：最终纳入91例疑诊为冠心病的冠状动脉造影大致正常的患者。与冠状动脉造影存在异常的1192例患者的相比，冠脉造影大致正常组中无危险因素者占20.1%，单一高危因素者占50.5%，显著高于冠脉造影异常组，而多重高危因素者占28.6%，显著低于冠脉造影异常组（P＜0.05）。91例疑诊为冠心病的冠状动脉造影大致正常的患者中心脏神经官能症及心律失常分别占45例（49.5％）及12例(13.2％)。结论：临床上很多疑诊为冠心病的胸痛患者的冠状动脉造影大致正常，这部分患者与冠状动脉异常的患者相比冠心病的危险因素更少，胸痛由其他原因引起，所以对这部分患者应强调应用无创的检查手段。

Clinical Study of Chest Pain Patients with Normal Coronary Artery

ABSTRACT Objective: To investigate the clinical characteristics and etiology of patients with chest pain and with normal coronary artery. Methods: From January 2019 to May 2021, 1283 patients who had chest pain and were suspected of coronary atherosclerotic heart disease and underwent coronary angiography in our hospital was retrospectively analyzed. Clinical datas such as the demographic data, risk factors were extracted and compared between patients with normal coronary angiography and abnormal normal coronary angiography. The etiology of chest pain in patients with normal coronary angiography was analyzed. Results: Finally, 91 patients with suspected coronary artery disease whose coronary angiography were generally normal were enrolled. Compared with 1192 patients with abnormal coronary angiography, 20.1% had no risk factor of cardiovascular diseases and 50.5% had a single high-risk factor in the normal coronary angiography group, which was significantly higher than the abnormal coronary angiography group. What''s more, 28.6% patients had multiple risk factors in the normal coronary angiography group, which was significantly lower than that of the abnormal coronary angiography group(P<0.05). Among 91 patients suspected of coronary heart disease, 45 cases were cardiac neurosis(49.5%) and 12 cases were arrhythmia(13.2%). Conclusion: In clinical, many patients with chest pain have normal coronary angiography. Compared with patients with abnormal coronary arteries, these patients have fewer risk factors for coronary heart disease, the symptom of chest pain werecaused by other reasons, so we should emphasize the application of noninvasive examination methods in these patients.