急性心肌梗塞后早期心绞痛的临床分析  

Clinical analysis of patients with postinfarction angina

作　　者：徐义枢[1] 杨跃进[1] 魏庆林[1] 刘恒伟 陈纪林[1] 于全俊[1] 高润霖[1] 陈在嘉[1] 

机构地区：[1]北京阜外心血管病医院,邢台市人民医院,邯郸钢铁厂职工医院

出　　处：《中华心血管病杂志》1995年第3期171-173,共3页Chinese Journal of Cardiology

摘　　要：本组急性心肌梗塞１０９０例中，发病后第２至２８天，有梗塞后早发性心绞痛３７９例（３４．８％）。３７９例心绞痛发作１７３９次，平均每例４．６次。其中２８７例（７６．３％）心绞痛的发作是在静息或（和）轻微的活动状态。有心绞痛史、心肌梗塞史或高血压史者，在梗塞后有与无心绞痛组中，分别占７８．１％与６２．２％（Ｐ＜０．００１）；４０．９％与２９．７％（Ｐ＜０．００１）；６３．３％与５５．６％（Ｐ＜０．００１），梗塞后有心绞痛者非常显著地多于无心绞痛者。非Ｑ波梗塞，在梗塞后有心绞痛组非常显著地多于无心绞痛组（４６．４％与２８．１％，Ｐ＜０．００１）。住院４周的病死率，在梗塞后有心绞痛组明显地低于无心绞痛组（２．９％与６．９％）。本组的临床特点提示：梗塞后有心绞痛者可能比无心绞痛者冠状动脉血管病变广泛。Abstract Early postinfarction angina (2-28 days after infarction) occurred in 379 (34. 8%) cases out of 1090 consecutive patients with acute myocardial infarction.There were totally 1739 episodes of angina with a mean of 4. 6 episodes per case, and 46. 2% of the episodes were between the second and the fourth day after infarction. Of the 379 patients with angina, the episodes of which in 287 (76. 3%) were at rest or minimal effort.A history of stable angina (78.1% vs 62. 2% , P<0. 001) , of old infarction (40. 9% vs 29. 7% , P<0. 001) and hypertension (63. 3% vs 55. 6%, P<0.001) were found significantly more in patients with postinfarction angina than in those without angina.Non-Q wave infarction occurred more frequently in patients with angina than in those without angina (46. 4%vs 28.1%, P<0. 001 ). However , hospital mortality (4weeks) in patients with early postinfarction angina was 2. 9% , which was significantly less than 6. 9% in those without angina (P<0. 05). The clinical features suggest that coronary artery disease is more extensive in patients with early postinfarction angina compared with those without angina.

关 键 词：心肌梗塞 心绞痛 病理 临床分析 

分 类 号：R541.402[医药卫生—心血管疾病] R542.220.6[医药卫生—内科学]