1型与2型Wellens综合征冠脉病变及风险评估对比研究
Comparison of coronary artery lesions and risk assessments between patients with type 1 and type 2 Wellens' syndrome

目的:探讨1型与2型Wellens综合征(WS-1/WS-2型)冠状动脉病变程度以及两型之间风险评估的差异。方法:收集2016年1月至2017年5月符合Wellens综合征诊断标准的45例住院患者的临床资料,根据心电图V2、V3导联T波形态改变分为WS-1型组(T波深倒置; n=33)和WS-2型组(T波双向; n=12),比较两组患者的基本信息、化验检查、胸导联T波倒置幅度、冠脉造影与心脏超声结果以及心肌梗死溶栓试验(TIMI)危险评分等各项参数。结果:WS-2型组左前降支动脉(LAD)最大狭窄程度比WS-1型组重,TIMI危险评分比WS-1型组高,血浆NT-proBNP值比WS-1型组高(P均<0.05),T波倒置幅度比WS-1型组小(P<0.05); 而两组冠脉Gensini积分、LAD最大狭窄位置、LAD的TIMI血流分级、左室射血分数、左室壁运动异常比较差异均无统计学意义(P>0.05)。结论:WS-2型患者LAD狭窄程度比WS-1型重,危险程度更高。
Aim: To explore the differences between type 1(WS-1)and type 2 Wellens' syndrome(WS-2)in terms of lesions of coronary arteries and risk assessments.Methods: From January 2016 to May 2017, 45 consecutive hospitalized Wellens' syndrome patients were included and the clinical data of them were collected. They were divided into WS-1 group(inverted T wave; n=33)and WS-2 group(biphasic T wave; n=12)by different T wave patterns, and the basic information, laboratory inspections, amplitude of inverted T waves, CAG findings, echocardiographic data and thrombolysis in myocardial infarction(TIMI)risk scores were compared.Results: The degree of maximal stenoses of left anterior descending arteries(LAD)and TIMI risk scores in WS-2 group were significantly higher than those in WS-1 group(P<0.05). WS-1 group had deeper inverted T waves and lower NT-proBNP levels than those in WS-2 group(P<0.05). However, no significant difference was found between the two groups in Gensini scores, location of maximal stenoses in LAD, TIMI blood flow degree of LAD, left ventricular ejection fraction or wall motion abnormalities(P>0.05).Conclusion: The degree of LAD stenosis of WS-2 is more severe than that of WS-1. WS-2 is more dangerous than WS-1