摘要
目的回顾性分析比较首次发生急性ST段抬高心肌梗死与非ST段抬高心肌梗死的临床及冠状动脉病变的特点。方法选择首次急性ST段抬高心肌梗死患者50例(ST段抬高组)和急性非ST段抬高心肌梗死患者50例(非ST段抬高组),均行冠状动脉造影检查,对其发病特点、临床表现、并发症、心功能以及冠状动脉病变进行回顾性分析。结果 ST段抬高组起病急,主要以剧烈胸痛为主,就诊时间较早,非ST段抬高组首发症状多样。ST段抬高组总并发症、室性心律失常、窦性心动过缓及传导阻滞发生率明显高于非ST段抬高组(P<0.01),左心室射血分数明显低于非ST段抬高组(P<0.05)。与ST段抬高组比较,非ST段抬高组冠状动脉病变血管支数较多,3支病变、侧支循环比例较高(P<0.05,P<0.01)。结论急性ST段抬高心肌梗死起病急,并发症多,影响心功能,应积极尽快实施血运重建,以开通梗死相关血管,但急性非ST段抬高心肌梗死冠状动脉病变往往较重。急性心肌梗死的近期预后与起病急缓、透壁性心肌坏死范围等有关。
Objective To retrospectively analyze the clinical features of acute myocardial infarction with or without first ST segment elevation and coronary artery lesions. Methods One hundred myocardial infarction patients were divided into ST segment elevation group（n= 50） and non-ST segment elevation group （n = 50） and underwent coronary arteriography. Characteristics, clinical manifestations, complications of the disease, cardiac function and coronary artery lesions of the patients were retrospectively analyzed. Results The disease was acute in ST segment elevation group and mainly manifested as sharp chest pain, while the symptoms of nonT segment elevation group were various. The incidence of complications, ventricular arrythythmias, sinoatrial bradycardia,and conduction block was significantly higher while the left ventricular ejection fraction was significantly lower in ST segment elevation group than in non-ST segment group（P〈 0.05）. The number of lesions-involved blood vessels and the proportion of collateral circulation were higher in ST segment elevation group than in non-ST segment group（P〈0.05）. Conclusion Acute myocardial infarction usually occurs in ST segment elevation patients with more complications,thus inlluencing their cardiac function. It should be treated with active reperfusion in order to promote the circulation of infarction-related blood vessels. The coronary artery lesions are severer in non-ST segment elevation patients. The short-term prognosis of acute myocardial infarction patients is associated with such factors as the onset time, infarction size and myocardial necrosis.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第4期361-363,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
心肌梗死
冠状动脉疾病
胸痛
冠状血管造影术
心电描记术
心律失常
心性
myocardial infarction
coronary artery disease
chest pain
coronary angiography
electrocardiography
arrhythmias, cardiac
