摘要
目的:探讨急性心肌梗死(acute myocardial infarction,AMI)并发心脏破裂(cardiac rupture,CR)的临床特征、早期诊断及防治方法。方法:连续选取我院2002年3月至2010年3月住院确诊为急性心肌梗死的1 526例患者,经超声心动图或心包穿刺证实为心脏破裂的30例患者,结合冠状动脉造影结果进行分组分析。结果:1.发生CR患者年龄明显高于无破裂者(P<0.05);女性高于男性(P<0.05);2.合并高血压、糖尿病、血肌酐异常患者易发生CR;3.急性ST段抬高性前壁AMI并发CR的发生率明显增高(P<0.05);4.左心室舒张末径增大,射血分数(EF)<50%者易发生CR(P<0.05);LAD严重病变尤其是开口病变及LAD合并3支血管病变发生率明显增高(P<0.05);5.早期成功再灌注治疗者CR发生率明显少于无再灌注者(P<0.05)。结论:AMI合并CR预后明显欠佳。女性、高龄、前壁梗死、LAD严重病变及延迟再灌注患者易于发生。床旁超声心动图有助于早期诊断,积极预防及早期成功再灌注治疗可减少CR的发生。
Objective：To analyze the characteristics,early diagnosis and the suitable therapy of cardiac rupture（CR） in patients with acute myocardial infarction（AMI）.Methods：1 526 consecutive cases of AMI from March 2002 to March 2010 were selected.Combining coronary angiography,30 cases occurred CR that confirmed by echocardiogram or pericardiocentesis were analyzed.Results：1.Patients with CR were older than those without CR.The incidence of CR in female were significantly high than that in male.2.Patients who accompanied with hypertension,diabetic mellitus,abnormal renal function were more likely to occur CR.3.The incidence of CR in anterior infarction group was significantly higher than that in inferior infarction group and non-ST elevated infarction group.4.Patients who accompanied with enlarged LVEDD,EF less than 50% and LAD lesion especial LAD ostium also LAD accompanied three vessel lesion were more likely to occur CR.5.Patients with successful reperfusion were significantly less likely to occur CR.Conclusion：The prognosis of CR after AMI were poor.Patients who were female,older and who were with anterior infarction or severe LAD lesion,delayed reperfusion were more likely to occur.Bedside UCG is useful for early diagnosis and successful reperfusion early could reduce the incidence of CR.
出处
《心肺血管病杂志》
CAS
2011年第4期277-279,共3页
Journal of Cardiovascular and Pulmonary Diseases
关键词
急性心肌梗死
心脏破裂
心脏疾病
Acute myocardial infarction
Cardiac rupture
Heart disease
