以晕厥为首发症状的老年性急性心肌梗塞的临床分析  

Clinical analysis of acute old myocardial infarction with first symptoms of syncope

作　　者：张馥[1] 田福利[1] 永福[1] 杜日映[2] 安东记[1] 席小芬[1] 袁芳[1] 刘艳明[1] 刘向东[1] 

机构地区：[1]河北张家口251医院心内科,075000 [2]第四军医大学唐都医院心内科

出　　处：《罕少疾病杂志》2000年第2期9-11,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨以晕厥为首发症状的老年性急性心肌梗塞的临床改变与冠状动脉病变的相互关系。方法 由 16例老年性急性心肌梗塞的心电图首发改变，分为窦缓、窦停和房室传导阻滞 (AVB)三组，以冠状动脉造影的结果为依据，对其临床表现、心肌酶学检测和心电图的定位诊断进行对比研究。结果 结果显示三组病人的临床表现相似。心电图定位诊断与下壁、正后壁、右室和侧壁有关。心肌酶学中肌酸磷酸肌酶 (CK— MB)峰值的高低与梗塞面积大小和 AVB存在与否有正相关性。冠状动脉造影显示 AVB组的冠状动脉病变的支数和狭窄程度较窦缓组和窦停组严重，尤其是优势型冠状动脉狭窄程度最突出。结论 以晕厥为首发症状的老年性心肌梗塞的临床症状不明显，心电图常以窦缓、窦停或 AVB为其突出改变，对应冠状动脉造影显示三组病变与冠脉病变的支数和狭窄程度有关，尤其是优势型的冠状动脉严重狭窄是 AVB发生的重要的独立因素。Objective To study the relationship between acute old myocardial infarction (AOMI)with first symptoms of syncope and coronary artery lesions. Method 16 patients with AOMI were divided into sinus bradycardia (SB),sinus arrest (SA) and atrioventricular block (AVB) group. The relationship among three groups with clincal presentation, cardiac enzyme, electrocardiographic(ECG) locating criteria and coronary angiographic results were analysed.Results Three groups patients had same clinical features. The electrocardiographic localization for AOMI indicated SB in inferior leads, SA in inferior＋ lateral leads, and AVB in inferior＋ lateral＋ right ventricular＋ posterior leads. The peak value of creatine kinase isoenzyme (CK－ MB) with the range of AOMI and the ocurrence of AVB had positive relationship (P

关 键 词：晕厥 心肌梗塞 心电图 冠状动脉造影 冠脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病] R441.2[医药卫生—内科学]