两类型AMI患者临床、心功能及冠脉病变特点的差异  

Differences of clinical,cardiac function and coronary artery disease characteristics between two types of AMI

作　　者：任勇[1] 刘海[1] 徐果[2] 汤永谦[1] 刘文卫[1] REN Yong LIU Hai XU Guo TANG Yong-qian LIU Wen-wei(Department of Cardiology, Central Hospital of Xiangyang City, Xiangyang, Hubei, 441021, China)

机构地区：[1]湖北文理学院附属医院(襄阳市中心医院)心血管内科,湖北襄阳441021 [2]湖北文理学院附属医院(襄阳市中心医院)骨科,湖北襄阳441021

出　　处：《心血管康复医学杂志》2016年第5期528-531,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨两类型急性心肌梗死(AMI)患者临床、心功能及冠脉病变特点的差异。方法:选择本院收治的124例AMI患者为研究对象,根据患者心电图表现分为ST段抬高型AMI(STEMI组)68例及非ST段抬高型AMI(NSTEMI组)56例,对比分析两组临床特点、并发症及冠脉病变特点。结果:STEMI组临床表现为胸痛明显、就诊时间较早,心绞痛史比例明显低于NSTEMI组(17.65%比44.64%,P=0.003)。与NSTEMI组比较,STEMI组窦性心动过缓(0%比11.76%)、室性心律失常(0%比10.29%)及传导阻滞(0%比11.76%)发生率及总并发症发生率(25.00%比44.12%)明显升高,心肌肌钙蛋白T[cTnT,(2.69±0.78)ng/ml比(8.79±2.78)ng/ml]、肌酸激酶同工酶[CK-MB,(112.12±52.42)mmol/L比(182.32±78.23)mmol/L]水平明显升高,侧支循环(41.17%比17.65%)、3支冠脉病变(50.0%比14.7%)比例明显降低(P<0.05或<0.01)。两组心功能无统计学差异(P>0.05)。结论:ST段抬高型心肌梗死患者发病急,并发症发生率高,应尽早重建血运。非ST段抬高型心肌梗死患者三支病变比例高,患者病发前常存在缺血预适应。Objective：To explore differences of clinical,cardiac function and coronary artery disease characteristics between two types of acute myocardial infarction（AMI）.Methods：A total of 124 AMI treated in our hospital were enrolled.According to their ECG results,they were divided into ST elevation AMI（STEMI）group（n=68）and non-ST elevation AMI（NSTEMI）group（n=56）.Clinical characteristics,complications and coronary artery lesion features were compared and analyzed between two groups.Results：Clinical manifestations of STEMI group were obvious chest pain and early visit to hospital,percentage of angina pectoris history in STEMI group was significantly lower than that of NSTEMI group（17.65% vs.44.64%,P=0.003）.Compared with NSTEMI group,there were significant rise in incidence rates of sinus bradycardia（0% vs.11.76%）,ventricular arrhythmia（0% vs.10.29%）,conduction block（0% vs.11.76%）and total complications（25.00% vs.44.12%）;in levels of cardiac troponin T[cTnT,（2.69±0.78）ng/ml vs.（8.79±2.78）ng/ml]and creatine kinase isoenzyme MB [CK-MB,（112.12±52.42）mmol/L vs.（182.32±78.23）mmol/L];and significant reductions in percentages of collateral circulation（41.17% vs.17.65%）and triple-vessel coronary disease（50.0% vs.14.7%）in STEMI group（P〈0.05 or 0.01）.There were no significant difference in cardiac function between two groups（P〈0.05）.Conclusion：STEMI onset is acute with high incidence of complications,thus these patients should receive revascularization as soon as possible.Proportion of triple-vessel coronary disease is high in NSTEMI patients,and they usually present ischemic preconditioning before onset.

关 键 词：心肌梗死 心室功能 肌钙蛋白T 

分 类 号：R542.220.9[医药卫生—心血管疾病]