急性心肌梗死患者侧支循环形成的临床特征分析  

Analysis of clinical features of collateral circulation in patients with acute ST-segment elevation myocardial infarction

作　　者：郭文超 熊永红[1] 惠永明 Guo Wenchao;Xiong Yonghong;Hui Yongming(Department of Cardiology,Fengtai Hospital of Beijing City,Beijing 100071)

机构地区：[1]北京丰台医院心内科,北京100071

出　　处：《中国社区医师》2020年第31期20-21,共2页Chinese Community Doctors

摘　　要：目的:总结急性心肌梗死(AMI)患者的临床特点及冠脉病变情况,探讨AMI早期侧支循环形成的影响因素。方法:2015年9月-2019年9月收治AMI行经皮冠状动脉介入治疗并住院治疗的患者270例,根据侧支循环形成情况分为侧支循环差(PDC)组和侧支循环较好(WDC)组;再选取同期住院患者270例,作为对照组。比较3组患者临床资料及冠状动脉病变特点,并进行AMI相关动脉急性侧支循环发生影响因素的回归分析。结果:WDC组多支病变率及Gensini积分均高于PDC组,差异有统计学意义(P<0.05)。冠脉病变部位在侧支循环形成上有差异,RCA病变相较LAD及LCX病变更易形成侧支循环,在形成的侧支循环中LAD-RCA的侧支较LCX-RCA的侧支常见,LAD-LCX的侧支形成相对较少。WDC组心率及血压水平均高于PDC组,血清磷水平低于PDC组,差异有统计学意义(P<0.05)。回归分析结果显示:心率、MAP、血清磷离子水平、Gensini评分是梗死相关动脉急性侧支循环发生的影响因素(P<0.05)。结论:心肌梗死是形成侧支循环的启动因子,冠状动脉病变程度是侧支循环的独立影响因素,在AMI早期,较高的心率、平均动脉压有助于侧支的形成,血清磷离子水平影响侧支循环的程度。Objective:To summarize the clinical characteristics and coronary lesions in patients with acute myocardial infarction(AMI)and to explore the influencing factors of early collateral circulation formation of AMI.Methods:From September2015 to September 2019,270 inpatients with AMI who underwent PCI were enrolled,according to the formation of collateral circulation,they were divided into poor collateral circulation(PDC)group and well collateral circulation(WDC)group,then 270 inpatients were selected as control group.The clinical data and characteristics of coronary artery disease were compared among the three groups,and the influencing factors of acute collateral circulation of AMI related artery were analyzed by regression analysis.Results:The lesion rate of multiple collateral artery and the Gensini score of WDC group were significantly higher than that of PDC group,the differences were statistically significant(P<0.05).The location of coronary artery disease was different in the formation of collateral circulation,compared with LAD and LCX lesions,RCA lesions were more likely to form collateral circulation,the collaterals of LAD-RCA were more common than those of LCX-RCA 13 in the formation of collateral circulation,the collaterals of LAD-LCX were relatively few.The heart rate and blood pressure level of WDC group were higher than that of PDC group,the serum phosphorus ion concentration of WDC group was significantly lower than that of PDC group,the differences were statistically significant(P<0.05).The results of regression analysis showed that heart rate,map,serum phosphorus level and Gensini score were the influencing factors of acute collateral circulation(P<0.05).Conclusion:Myocardial infarction is the initiation factor of collateral circulation and the degree of coronary artery lesion is the independent influence factor of collateral circulation.In the early stage of acute myocardial infarction,higher heart rate and mean arterial pressure can contribute to the formation of collateral and the level of serum p

关 键 词：急性心肌梗死 冠脉侧支循环 心率 平均动脉压 

分 类 号：R542.22[医药卫生—心血管疾病]