早期心肌再梗塞和梗塞延展的临床分析  

A clinical analysis of early myocardial reinfarction and myocardial infarct extension

作　　者：徐义枢[1] 陆宗良 寇文镕 姚康宝 魏庆林[1] 刘恒伟 逯素芬 陈在嘉 

机构地区：[1]中国医学科学院阜外医院,邢台市人民医院,邯郸钢铁厂职工医院,北京特殊钢厂医院

出　　处：《中华心血管病杂志》1994年第6期409-410,共2页Chinese Journal of Cardiology

摘　　要：分析急性心肌梗塞１１０６例，住院中发生梗塞延展和早期再梗塞分别有６７例（６．１％）和１１例（１．０％）。梗塞延展和再梗塞发生在初始梗塞后平均１０±７天。梗塞后早期有心绞痛患者中，梗塞延展和再梗塞的发生，非常显著地多于无心绞痛患者（１３．２％与３．７％，Ｐ＜０．００１）。梗塞延展和再梗塞患者与无梗塞延展和无再梗塞患者比较，Ｋｉｌｌｉｐ高级别者多，更多地死于心源性休克。早期再梗塞和梗塞延展患者的住院病死率明显地高于无梗塞延展和无再梗塞患者（１１．５％和５．０％，Ｐ＜０．０５）。结果提示，梗塞后早发性心绞痛患者是早期再梗塞和梗塞延展的高危者，对早期再梗塞和梗塞延展患者应持续或延长监护及充分有效的药物治疗或（和）行介入性治疗或外科搭桥术。Abstract Early myocardial reinfarction (EM-reinfarction)and myocardial-infarct extension (MI-extension) were analysed in 1106 patients with acute myocardial infarction. Of all the patients with infarction, EM-reinfarction and MI-extension were detected in 11 (1.0 percent) and 67 (6.1 percent) cases, respectively. The occurrence of EM-reinfarction and MI-extension was on an average of 10±7 days after infarction. The incidence of EM-reinfarction and MI-extension was significantly higher in patients with early postinfarction angina than that in patients without early postinfarction angina (13.2% vs 3.7%, P<0.001). Compared with patients without EM-reinfarction and MI-extension, the patients with EM-reinfarction and MI-extension had higher grades in Killip class, more deaths due to cardiogenic shock. The hospital mortality was significantly higher in patients with MI-reinfarction and EM-extension than that in patients without EM-reinfarction and MI-extension (11.5 percent vs 5.0 percent, P<0.05).These results suggest that patients with early postinfarction angina are at particularly high risk for EM-reinfarction and Mi-extension and the patients with EM-reinfarction and MI-extension need to be continuouslyy monitored and treated actively either with medicine or interventional preocedures to improve the prognosis.

关 键 词：心肌梗塞 心绞痛 预后 再梗塞 临床分析 

分 类 号：R542.22[医药卫生—心血管疾病]