急性心肌梗死合并室间隔穿孔49例临床分析  

Clinical analysis of 49 cases with acute myocardial infarction complicated with perforation of interventricular septum

作　　者：曲巍[1] 于波[2] 

机构地区：[1]沈阳市第四人民医院,沈阳110016 [2]中国医科大学附属第一医院

出　　处：《内科急危重症杂志》2014年第5期325-326,共2页Journal of Critical Care In Internal Medicine

基　　金：辽宁省科技厅第一批科学技术计划项目(No:20122250834)

摘　　要：目的:探讨急性心肌梗死(AMI)并发室间隔穿孔(VSR)的临床特征及治疗方法,并进行预后分析。方法:回顾性总结49例AMI并发VSR患者的临床资料,评估治疗方法及预后。结果:AMI合并VSR患者中,VSR多位于前壁心尖及心尖附近;溶栓患者AMI^VSR时间间隔短于未溶栓患者;梗死部位以左前降支(LAD)36例(73.5%)为多;血清肌钙蛋白I(CnI)、C反应蛋白(CRP)(95.4±26.8)、N末端B型利钠肽原(N-BNP)(2389.8±982.7)μg/L均有明显升高;手术治疗30d及1年病死率均低于保守治疗。结论:AMI+VSR病死率高,手术治疗仍是确实有效的治疗方法。Objective： To investigate the clinical characteristics and prognosis of acute myocardial infarction （AMI） complicated with perforation of interventricular septum （VSP）. Methods： The clinical data of 49 cases with AMI complicated with VSP were analyzed, the treatment and prognosis were evaluated as well. Results： VSP mostly located at anterior apex. The interval between AMI and VSP was shorter in patients received thrombolytic therapy. The infarction sites were left an- terior descending branch （LAD） in 36 （73.5%） cases. CnI, C-reactive protein （CRP） [ （95.4 ±26.8） ] and N-BNP [ （2389. 8 ±982.7）μg/L] were ascended obviously. The 30 days and one year mortality of operation group was lower than conservative treatment. Conclusions： The mortality of AMI complicated with VSP is high, operation is the effective therapeutic method.

关 键 词：急性心肌梗死 室间隔穿孔 

分 类 号：R541.6[医药卫生—心血管疾病]