急性心肌梗死合并梗死区微血管阻塞的临床特点  

Clinical Features of Acute Myocardial Infarction with Microvascular Obstruction

作　　者：孟庆义[1] 杨晓秋[1] 钱远宇[1] 王志中[1] 马勇[1] 

机构地区：[1]中国人民解放军总医院急诊科,北京100853

出　　处：《天津医药》2003年第10期630-632,共3页Tianjin Medical Journal

摘　　要：目的 :探讨急性心肌梗死 (AMI)合并梗死区微血管阻塞 (microvascularobstruction ,MO)时的临床特点及意义。方法 :对44例AMI患者的心电图、心肌酶学和核磁共振成像等临床资料进行分析。结果 :(1)25 0 %(11 /44)的AMI患者存在MO。(2)MO组的梗死面积高于非MO组差别有统计学意义[(32 5±9 .6) %vs(18 8±12 .7) % ,t=3.430 ,P<0 .01)]。 (3)MO组行经皮冠状动脉成形术的比例 (36 6 % ,4 /11)少于非MO组 (78 8 % ,26 /33 ,χ2=6 .844 ,P<0 .01)。 (4)MO组有9 1 % (1 /11)的患者在住院期间发生梗死后心绞痛 ,与非MO组(39 4 % ,13 /33)比较 ,差别无统计学意义 (P>0 .05)。结论 :合并MO的AMI患者具有梗死面积大 。Objective:To investigate the clinical features of acute myocardial infarction(AMI)with mi-crovascular obstruction(MO).Methods:The electrocardiography,myocardial enzyme,and magnetic resonance imaging data in44patients with AMI were analyzed retrospectively.Results:(1)There was25.0%(11/44)AMI patients with MO.(2)The average infarct siza in MO patients was larger than that in non_MO group[(32.5±9.6)%vs(18.8±12.7)%,t=3.430,P<0.01)].(3)The MO group had a lower incidence of PTCA use com-pared with non_MO AMI patients(36.6%vs78.8%,χ 2 =6.844,P<0.01).(4)There was no significant differ-ence in the frequency of angina pectoris after infarction between MO and non_MO patients(9.1%vs39.4%,P>0.05).Conclusion:The larger infarct size and less PTCA use were present in AMI patients with MO.

关 键 词：急性心肌梗死 合并症 梗死区 微血管阻塞 临床特点 心电图 心肌酶学 核磁共振成像 

分 类 号：R542.22[医药卫生—心血管疾病]