不同类型急性心肌梗死冠状动脉病变特点的观察  

Characteristics of Infarct-Related Artery in Different Patterns of Acute Myocardial Infarction

作　　者：洪衡[1] 王明生[1] 王河[1] 李明昌[1] 王磊[1] 肖毅[1] 杨光[1] 王红梅[1] 任海明[1] 贾宁[1] 谭丽玲[1] 顼志敏[2] 

机构地区：[1]北京市石景山医院心内科,100043 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院

出　　处：《中国循环杂志》2007年第3期187-190,共4页Chinese Circulation Journal

摘　　要：目的:从临床角度更深入理解急性ST段抬高性心肌梗死(STEMI)或急性非ST段抬高性心肌梗死(NSTEMI)的冠状动脉病变特点。方法:入选2003年12月至2006年9月间,症状发作24小时内行冠状动脉造影的急性心肌梗死(AMI)患者,选择造影结果提示梗塞相关血管为次全闭塞或未闭塞的患者为急性STEMI组(42例),与梗塞相关血管为完全闭塞的患者为急性NSTEMI组(16例)比较两组患者病变特点。结果:急性STEMI组的梗塞相关血管均为主支血管,而急性NSTEMI组梗塞相关血管非主支血管较多,急性STEMI组与急性NSTEMI组相比,有显著性差异[0例vs6例(37.5%),P<0.05]。急性STEMI组梗塞相关血管病变位于主支血管的近段或中段较急性NSTEMI组为多,有显著性差异[38例(90.5%)vs7例(43.8%),P<0.05]。梗塞相关血管造影可见侧支者,急性STEMI组较急性NSTEMI组少,有显著性差异[10例(23.8%)vs10例(62.5%),P<0.05]。结论:与急性NSTEMI患者相比,急性STEMI患者中,梗塞相关血管病变位于主支冠状动脉及其近中段者较多,而侧支循环较少。Objective：To investigate the characteristics of infarct-related aftery （IRA）in patients with acute myocardial infarction with electrocardiogram （ECG） showing ST-segment elevation （STEMI） or non-ST-segment elevation（NSTEMI）. Methods： From December 2003 to September 2006, the patients who had confirmed diagnosis of acute myocardial infarction and experienced emergency angiography within 24 hours from the heart attack were enrolled. Among them, the artery＇ lesion characteristics of the 42 patients with STEMI whose angiography showing non-total occlusion of IRA were compared with those of the 16 patients with NSTEMI whose angiography showing total occlusion of IRA. Results：①All the IRAs of STEMI cases were main arteries;While in NSTEMI group, there were 6 patients （37.5%） with IRAs not main arteries. There were more lesions located in proximal or medial position of main arteries in STEMI group than in NSTEMI group[38（90. 5% ） vs 7（43.8% ） ,P 〈0. 05.②The patients in NSTEMI group had more collateral branches to IRAs than those in STEMI group[10 （62.5%）vs 10（23.8% ） P 〈0. 05 ]. Conclusion： There were more patients with IRA lesions locating in main coronary arteries,proximal or medial position, but less collateral branches in STEMI group than in NSTEMI group.

关 键 词：冠状动脉病变 急性ST段抬高性心肌梗死 急性非ST段抬高心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]