急性心肌梗死生化指标及症状与梗死部位的关系分析  

Relationship of biochemical criteria and symptoms with infarction position in acute myocardial infarction patients

作　　者：王越红[1] 王宇楠[2] 侯天华[3] 苏文亭[4] 赵宇[5] 石铭宇[1] 吴磊[1] 李为民[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心内科,150001 [2]赤峰市医院心内二科,内蒙古024000 [3]承德市中心医院心内科,河北067000 [4]阜外心血管病医院心内科,北京100037 [5]哈尔滨医科大学附属第一医院检验科,150001

出　　处：《中国急救医学》2010年第10期924-926,共3页Chinese Journal of Critical Care Medicine

基　　金：基金项目：黑龙江省教育厅2009年度科学技术研究面上项目（No.11541126）;黑龙江省卫生厅2009年度科研课题（No.2009-051）;哈尔滨医科大学附属第～医院科研基金（No.Q08-024）

摘　　要：目的 探讨不同类型急性心肌梗死（AMI）患者生化指标及症状与心肌梗死部位的相互关系.方法 选取曾经入我院的150例AMI患者.根据心电图表现将其分为两组：前壁梗死组和下壁梗死组.观察指标为：①临床症状分析：根据其病例资料回顾性地进行胸痛、恶心、呕吐症状分析;②实验室检查指标：采用半定量免疫法测定血清肌钙蛋白I（TnI）,生化分析仪测定肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）.③分析每组症状与实验室指标发生与变化情况,并进行两组比较.结果 150例AMI患者中,前壁、下壁梗死组分别为58例（38.7%）、92例（61.3%）.血清TnI、CK、CK-MB峰值在前壁、下壁梗死组分别为189.7/76.4（ng/mL）、1890/976（U/L）、146.3/101.5（ng/mL）,两组比较有显著性差异（P〈0.05）.胸痛、恶心、呕吐症状在前壁、下壁梗死组中分别为56/88例（97%/96%）、32/58例（55%/63%）、14/29例（24%/32%）,两组比较无统计学差异（P〉0.05）.结论 前壁梗死组患者的TnI、CK、CK-MB峰值明显高于下壁梗死组患者,而胸痛、恶心、呕吐症状与心肌梗死部位无关.Objective To study the relationship of the biochemical criteria and symptoms with infarction positions in the patients with acute myocardial infarction （AMI）. Methods 150 patients were admitted to our hospital for acute ST - segment elevation myocardial infarction （ ASTEMI ）. The presenting symptoms （chest pain, nausea and vomiting） , patient history, electrocardiographic findings, laboratory examination and the infarction positions were extracted from the medical records. Results In all 150 patients with ASTEMI, 58 patients （38.7%） had anterior infarction and 92 patients （61.3%） had inferior infarction. The values of troponin I （ TnI ）, CK and CK - MB were 189.7 ng/mL and 76.4 ng/mL, 1890 U/L and 976 U/L, 146.3 ng/mL and 101.5ng/mL in anterior infarction group and inferior infarction group, respectively. The differences were statistically significant （ P 〈 0.05 ）. Chest pain was reported in almost all patients （56/88, 97%/96% ）. Nevertheless nausea and vomiting were reported in 32/58 （ 55%/63% ） and 14/29 （ 24%/32% ） patients, respectively. However, the differences were not statistically significant（P 〉 O. 05 ）. Conclusion The values of TnI, CK, CK - MB are higher in the patients with anterior infarction than with inferior infarction. Chest pain, nausea and vomiting are not related to the infarction position.

关 键 词：急性心肌梗死 生化指标 症状 梗死部位 

分 类 号：R542.22[医药卫生—心血管疾病]