急性心肌梗死中侧支循环形成影响因素的研究  

Study on determinants of collateral developments in acute myocardial infarction

作　　者：徐立庆[1] 周旭晨[2] 栗印军[1] 

机构地区：[1]沈阳市第四人民医院心血管内科,辽宁沈阳110031 [2]大连医科大学附属一院心脏中心,辽宁大连116023

出　　处：《中国医药导报》2011年第4期41-43,共3页China Medical Herald

摘　　要：目的:通过运用冠脉造影和非介入性方法研究急性心肌梗死(AMI)时影响侧支循环开放和形成的因素。方法:共有50例AMI患者均在AMI发作3 d内行冠状动脉造影术(CAG),根据CAG判断侧支循环的分级情况,将患者分为侧支良好组(A组:侧支循环2、3级)和侧支不良组(B组:侧支循环0、1级),将两组AMI患者的冠脉造影资料和临床资料进行对比分析。结果:两组患者在梗死相关动脉(IRA)、左冠脉优势、病变部位及病变支数等方面的指标差异无统计学意义。多因素Logistic回归分析(前进法)揭示了心绞痛病程>3个月是急性心肌梗死时侧支循环形成与否的唯一影响因素。结论:在急性心肌梗死时是否出现良好侧支循环方面,冠脉病变支数、冠脉病变部位、IRA及冠脉优势类型均无明显的影响作用。心绞痛病程(>3个月)是影响急性心肌梗死发作后良好侧支循环是否及时出现的唯一的独立因素。Objective： To identify the factors that could influence the presence of collateral vessels by means of coronary angiography′s（CAG） and non-invasive ways as soon as AMI happened.Methods ： 50 cases of patients with acute myocardial infarction underwent PTCA within 3 days after onset of a first AMI.All patients were divided into two groups（A and B） on the basis of whether the collateral vascular was found during the coronary angiography.Patients in group A（n=21） had collateral vascular（grade 2,3）,whereas patients in group B（n=29） had collateral vascular（grade 0,1）.The data of group A and group B in clinic and CAG were analyzed and compared.Results： The results of CAG revealed that the presence of collaterals had no relations with the number of coronary artery occluded and the coronary proximal location as well as the left dominant coronary artery and IRA.By multiple regression analysis,duration of angina（3 months） was correlated independently with presence of collateral vascular in AMI.Conclusion： The presence of collaterals has no relations with the number of coronary artery occluded and the coronary proximal location as well as the left dominant coronary artery and IRA.The duration of angina（3 months） is correlated independently with presence of collateral vascular in AMI.

关 键 词：急性心肌梗死 侧支循环 冠脉造影 

分 类 号：R514.4[医药卫生—内科学]