伴与不伴心绞痛的陈旧性心肌梗死患者临床冠状动脉造影的研究  

Clinical and coronary angiograph ic study on patients with old myocardial infarction

作　　者：李果明[1] 夏小明[1] 许金成[1] 詹贤章[2] 

机构地区：[1]广东医学院附属医院心内科 [2]广东省心血管病研究所,广东湛江524001

出　　处：《广东医学院学报》2001年第4期255-256,共2页Journal of Guangdong Medical College

摘　　要：目的 :为了更好地认识陈旧性心肌梗死 (OMI) ,我们对 65例 OMI患者的临床资料及冠状动脉造影结果进行了回顾性研究。方法 :65例均接受心电图、超声心动图、冠状动脉造影及左心室造影 ,根据有无心绞痛 (AP)分为两组。结果 :血脂水平、高血压及糖尿病伴发情况、单支及多支血管病变率在两组间差异无显著性 (P>0 .0 5)。与无心绞痛组比较 ,心绞痛组非闭塞血管最大狭窄程度、梗塞相关血管(IRA)再通率、左室射血分数 (EF)较高 ,闭塞性血管病变率、左室扩张率较低 (P<0 .0 5～ 0 .0 1 )。在无心绞痛组内 ,EF <45%亚组与 EF≥45%亚组比较 ,前者的多支血管病变率较高 ,IRA再通率较低 (P<0 .0 5)。结论 :(1 ) OMI患者合并心绞痛与存在严重狭窄的冠状动脉病变有关 ;(2 ) OMI患者 EF与 IRA再通、心梗范围及部位、冠状动脉病变的严重程度及左室扩张有关 ;(3) OMI无 AP且心功能正常者预后较后 ,心功能严重障碍或有 AP者预后欠佳 ,尤应注意无 AP症状而 EF<45%亚组 ,其高度危险性应予充分认识。Objective: To u nderst and old myocardial infarction(OMI) still better,the clinical and coronary an giographic features were reviewed re trospectively in 65 patients with OM I Methods: Sixty five consecutive pa tients with OMI who had been examine d with electrocardiograph,echocardiog raph,coronary angiography and left v entriculography were divided into 2 groups:group A with angina pectoris, and group NA without angina pectoris [HJ 5”:3]Results: There was no statistic a l difference between two groups in plasm a level of lipid,concomitant hyperte nsion or diabetes mellitus,and the r ates of one vessel and multi vessel lesions( P >0 05) Compared with group NA,the stenosis degree in non occlus ive vessels,the patent rate of infar ct related arteries(IRA) and the lef t ventricular ejection fraction(EF) were significantly higher,and the ra te of occlusive vessel lesions and t he dilation rate of left ventricle w ere markedly lower in group A( P <0 05 0 01) In group NA,the rate of multi vessel lesions was higher,and the p atent rate of IRA was lower in subgr oup with EF<45% than that in subgrou p with EF≥45%( P <0 05),respectively Conclusion: (1) There is a close rela tion between coexistent angina pecto ris and severe stenosis of coronary arteries (2) EF is associated with t he patency of IRA,the site and size of myocardial infarction,and the sev erity of coronary artery lesion and the left ventricular dilation (3) Th e prognosis of patients with EF ≥45% and without angina pectoris would b e better,and vice versa There is a h igh risk for those with EF<45% and w ithout angina pectoris and more atte ntion should be paid to

关 键 词：心肌梗死 心绞痛 左室射血分数 冠状动脉造影术 

分 类 号：R542.22[医药卫生—心血管疾病]