摘要
目的：分析比较非ST段抬高的急性冠状动脉综合征与ST段抬高的急性心肌梗死患者的心血管危险因素和影像学特征。 方法：选择2003-01／2004-04在南方医科大学南方医院心内科住院并 接受冠脉造影的冠心病患者，按照2002年美国心脏病学学院／美国心脏协会不稳定型心绞痛和非ST段抬高心肌梗死治疗指南及2000年中华医学会心血管病学分会的不稳定性心绞痛诊断和治疗建议进行诊断分类。非ST段抬高的急性冠状动脉综合征患者33例(非ST段抬高组)，男30例，女3例。ST段抬高的急性心肌梗死患者33例(ST段抬高组)，男27例，女6例。对两组患者的心血管危险因素和影像学特征进行对比统计分析。 结果：进入结果分析非ST段抬高急性冠状动脉综合征患者33例，ST段抬高急性心肌梗死患者33例。非ST段抬高组与ST段抬高组具有相同程度的冠心病危险因素年龄、血脂紊乱、高血压、肥胖、合并糖尿病、有吸烟史、有早发冠心病家族史(P>0．05)。非ST段抬高组患者具有2个以上心血管危险因素，其病变血管数与ST段抬高维相似；冠状动脉狭窄程度重于ST段抬高组[狭窄程度<50％：8，3例；50％～74％：9，9例；75％～99％：53，43例；100％：1，20例，Z=3．45，P=0．001]，但>75％以上严重的狭窄病变占总病变的76％。严重狭窄病变形态差于ST段抬高组(Z=3．23，P=0．001)。 结论：非ST段抬高的急性冠状动脉综合征与ST段抬高的心肌梗死患者具有相似的危险因素；ST段抬高的急性心肌梗死患者冠状动脉狭窄更严重，而且较严重的病变形态多于非ST段抬高的急性冠脉综合征患者。
AIM： To analyze and compare of the risk factors of cardiovascular disease and screenage characteristics of acute coronary artery syndrome without ST-segment elevation with acute myocardial infarction patients with ST-segment elevation. METHODS： The coronary heart disease patients, who accepted angiography at Department of Cardiology, Nanfang Hospital, Southern Medical University between January 2003 and April 2004, were selected. The diagnosis was classified according to unstable angina pectoris and myocardial infarction without ST-segment elevation treatment directory designed by American College of Cardiology/American Heart Association in 2002 and unstable angina pectoris diagnosis and treatment recommendation designed by institute of angiocardiopathy, China Medical Association in 2000. Thirty-three patients with acute coronary artery syndrome without ST-segment elevation （non-ST-segment elevation group）, including 30 males and 3 females, 33 patients with acute myocardial infarction with ST-segment elevation （ST-segment elevation group）, including 27 males and 6 females. Comparative statistical analysis on risk factor of cardiovascular disease and screenage characteristics in patients of the two groups was performed. RESULTS： Thirty-three patients with acute coronary artery syndrome without ST-segment elevation and 33 patients with acute myocardial infarction with ST-segment elevation were involved in the result analysis. The patients in the non-ST-segment elevation group and ST-segment elevation group had the risk factor of coronary heart disease in the same degree, that was, age, derangement of blood lipid, hypertension, obesity, integrated with diabetes, smoking history and family history of early coronary heart disease （P 〉 0.05）. The patients in the non-ST-segment elevation group had more than two risk factors of cardiovascular disease, and the number of lesion vessel was similar to that in the ST-segment elevation group; The coronary stricture degree was more severe than that in the ST-segment elevation group [stricture degree 〈 50%： 8, 3 cases; 50%- 74% ：9,9 cases;75% -99% ：53,43 cases; 100% ：1,20 cases,Z =3.45,P =0.001], but the 〉 75% severe constriction lesion accounted for 76% of the total lesion. The form of severe constriction lesion was worse as compared with the ST-segment elevation group （Z=3.23,P=0.001）. CONCLUSION： The patients with acute coronary artery syndrome without ST-segment elevation have the similar risk factors with the patients with myocardial infarction with ST-segment elevation; The coronary artery of patients with acute myocardial infarction with ST-segment elevation is severe constriction, and the more serious lesion form is more than that in the patients with acute coronary artery syndrome without ST-segment elevation.
出处
《中国临床康复》
CSCD
北大核心
2005年第35期76-78,共3页
Chinese Journal of Clinical Rehabilitation
