陈旧性心肌梗死梗死区域ST段急性抬高的临床意义  

CLINICAL SIGNIFICANCES OF ST SEGMENT ACUTE ELEVATION IN INFARCTED ZONE IN PATIENTS WITH OLD MYOCARDIAL INFARCTION

作　　者：姜志安[1] 张晓光[1] 肖文良[1] 赵淑健[1] 王士昌[1] 

机构地区：[1]河北医科大学第三医院心内科,河北石家庄050051

出　　处：《河北医科大学学报》2006年第2期98-100,共3页Journal of Hebei Medical University

摘　　要：目的探讨陈旧性心肌梗死（old myocardial infarction，0MI）梗死区域ST段急性抬高的临床意义。方法选择OMI合并急性冠脉综合征（acute coronary syndrme，ACS）时梗死区域ST段急性抬高13例，且首次发生急性心肌梗死时均未实施静脉溶栓、冠脉介入或冠脉搭桥。所有患者此次入院后进行冠状动脉造影（coronary artery angiography，CAG）检查。结果CAG结果证实所有患者的梗死相关动脉均仍是完全闭塞的，梗死区域的血运完全靠侧枝循环提供；提供侧支的供血血管狭窄70％～95％。结论这类OMI合并ACS梗死区域ST段抬高的实质是梗死区域残存心肌侧支循环明显减少甚至中断，此类患者采取溶栓无疑是错误的。Objective To explore the clinical significances of ST segment acute elevation in infarcted zone in patients with old myocardial infarction（OMI）. Methods Thirteen OMI patients with acute coronary syndrme（ACS） were included and the ST segment appeared acute elevation in electrocardiogram in old infarcted zone. No venous thrombolytic therapy, percutaneous coronary artery intervention and coronary artery bypass graft were used for all this patients in the first acute myocardial infarction. After they were admitted this time because of ACS, coronary artery angiography（CAG） were performed in all patients. Results The results of CAG indicated that infarction-related arteries in all patients were still totally occluded and blood supplies in the infarcted zone depended completely on collateral circulation by other vessels. The vascular stenosis of the collateral circulation vessels was from 70 % to 95 %. Conclusion The clinical significances of ST segment acute elevation in the infarcted zone in patients with OMI in this situation is that collateral circulation in the infarcted zone reduces remarkablely or even stops completely. Venous thrombolytic therapy in those patients is inappropriate undoubtly.

关 键 词：心肌梗塞 冠状动脉硬化 血栓溶解疗法 

分 类 号：R542.22[医药卫生—心血管疾病]