不同梗死相关血管的急性下壁心肌梗死的临床特征分析  

Clinical characteristics of acute inferior wall myocardial infarction patients with different culprit vessel undergoing intervention

作　　者：彭剑[1] 张治平[1] 陈国洪[1] 宋丹[1] 苏晞[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,430022

出　　处：《中国心血管杂志》2013年第1期6-8,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨右冠状动脉(RCA)和左回旋支(LCX)闭塞导致的急性下壁心肌梗死的临床特征。方法对连续收治的108例行急诊冠状动脉介入治疗的ST段抬高型急性下壁心肌梗死患者的临床资料进行分析,根据梗死相关血管分为两组:RCA闭塞致心肌梗死组85例(RCA组),LCX闭塞致心肌梗死组23例(LCX组),比较两组临床特征。结果 RCA组血清肌酐水平、三支血管病变、心力衰竭和三度房室传导阻滞患者比例均显著高于LCX组[(93±26)μmol/L比(79±15)μmol/L,38.8%比13.0%,34.1%比13.0%,18.8%比0,均为P<0.05],RCA组合并右心室心肌梗死的患者比例也显著高于LCX组(29.4%比0,P<0.01),两组患者右冠脉优势型、住院病死率差异无统计学意义(87.1%比69.6%,1.2%比0,均为P>0.05)。结论 RCA梗死相关的急性下壁心肌梗死患者发生心力衰竭、三度房室传导阻滞的比例高于LCX梗死相关的急性下壁心肌梗死患者。Objective To explore the clinical characteristics of right coronary artery （ RCA）-related or left circumflex artery （LCX）-related acute inferior wall myocardial infarction （AIMI） patients undergoing emergency percutaneous coronary intervention （PCI）. Methods A total of 108 consecutive patients with ST-segment elevation AIMI undergoing primary coronary angioplasty were retrospectively analyzed and were divided into two groups according the culprit vessel, RCA group （ with culprit vessel RCA, n = 85 ） and LCX group （with culprit vessel LCX, n = 23 ）. Clinical data and outcomes were compared between two groups. Results Serum creatinine level [ （93 ±26 ） μmol/L vs. （79 ± 15 ） μol/L, P 〈 0.05 ] and incidence of advanced congestive heart failure （34. 1% vs. 13.0% , P 〈 0. 05） and three-vessel disease （38.8% vs. 13.0% , P 〈 0.05 ） were significantly higher in RCA group than in LCX group. The incidence of right ventricular infarction （29. 4% vs. O, P 〈0. 01 ） and third degree atrioventricular block （ 18.8% vs. O, P 〈 0. 05 ） were significantly higher in RCA group than in LCX group. There were no significant differences in right coronary advantage type （87.1% vs. 69. 6% ） and hospital mortality （1.2% vs. O, both P 〉0. 05）. Conclusions This study demonstrated that RCA -related AIMI have a poorer heart function when compared with LCX -related AIMI.

关 键 词：心肌梗死 心力衰竭 经皮冠状动脉介入治疗 

分 类 号：R542.22[医药卫生—心血管疾病]