不稳定心绞痛的机理和防治新进展
江一清,方圻
摘要(Abstract):
<正> 不稳定心绞痛(UAP)极易发展为急性心肌塞梗(AMI)和猝死,发病率高,美国1987年住院75万人,非 Q 波 AMI 25万人,研究发病机理利于有效防治极为重要。UAP 曾称为"濒临心肌梗塞"和冠脉堵塞等,发展为 AMI 占44%~70%,Levyl58例随诊6年40%发展为非 Q 波 AMI,23%为典型 AMI,病死率16%,猝死率16%,全部病死率为32%,综合13篇资
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作者(Author): 江一清,方圻
参考文献(References):
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