目的探讨心脏瓣膜病伴发冠心病的诊断方法。方法对602例心脏瓣膜病术前临床资料和选择性冠状动脉造影结果进行综合分析。结果冠状动脉造影显示，心脏瓣膜病并发冠心病为14.1%，其中无症状者占76.2%。21例核素心肌灌注显像中阳性率为9.5%。结论选择性冠状动脉造影是确诊心脏瓣膜病伴发冠心病的最可靠的方法。在临床，大于50岁( 有冠心病危险因素者提前到40岁)、需心脏瓣膜置换的病人，术前应常规行选择性冠状动脉造影检查。%Objective: This article reported the results of coronary angiography in patients with valvular heart diease. Methods: Coronary angiography was performed in 602 patients with valvular heart disease before surgery. Results: The incidence of coronary artery disease in valvular disease was 14.1%. Of whom,76.2% were asymptomatic. Assaciated coronary artery disease was detected only in 9.5% of patients by none invasive radioisotope imaging method. Conclusion: Coronary arteriography is a reliable means to confirm the coronary artery lesion. The results suggest that preoperative selective coronary angiography should be performed routinely in patients over 50 years old (40 years old with coronary artery risk factors) before valve replacement.Patie nts with significant coronary disease should receive coronary bypass at the time of valve replacement.
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