摘要
①目的探讨非ST段抬高心肌梗死患者的临床特征及影像特点。②方法回顾性分析住院行选择性冠状动脉造影的急性非ST段抬高心肌梗死患者(NSTEMI)的住院资料,与同期住院行急诊冠状动脉造影的ST段抬高心肌梗死患者(STEMI)进行比较分析。③结果NSTEMI患者的心血管危险因素均高于STEMI患者:高血压(57.7%vs.40.3%,P<0.05)、糖尿病(31.8%vs.14.3%,P<0.05)、血脂代谢异常(27.2%vs.12.3%,P<0.05)。NSTEMI患者既往心绞痛(65.3%vs.0.2%)和心肌梗死(30.1%vs.11.7%)的发病史高于STEMI患者(P<0.05)。冠状动脉造影显示NSTEMI患者3支病变和慢性完全闭塞病变的发生率也高于STEMI(P<0.05)。NSTEMI患者的梗死相关动脉完全闭塞率为55.2%(132/239),明显低于STEMI患者的82.9%(651/785)(P<0.001);NSTEMI和STEMI患者梗死相关动脉出现侧枝循环发生率分别为:57.5%(137/239)、20.5%(161/785)(P<0.001)。④结论NSTEMI患者发病前常有心绞痛史;心血管危险因素多。冠脉造影显示其较STEMI患者有更严重的冠状动脉病变;但梗死相关动脉的闭塞率较低;而侧支循环水平较好。
Objective To investigate the characteristics of Patients with Non - ST - Segment Elevation Acute Myocardial In- farction. Methods The data of 1024 inpatients with acute myocardial infarction who underwent coronary angiography (CAG) from June 2005 to June 2011 were retrospectively analyzed. All the patients were divided into two groups: patients with ST - segment ele- vation myocardial infarction (STEMI) who received emergency CAG within 24 hours, and patients who received CAG within 3 days after the onset of non - ST - segment elevation myocardial infarction(NSTEMI). The incidences of hypertension, diabete, and dys- lipidemia in both groups were investigated. (IRA) were also calculated, and the levels of collateral circulation of IRA were evalua- ted in both groups. Results The higher incidences of hypertension(57.7% vs. 40.3% , P 〈0.05) , diabetes(31.8% vs. 14. 3%, P 〈 0.05 ), and dyslipidemia(27.2% vs. 12.3%, P 〈 0.05 ) occurred in patients with NSTEMI, compared with STEMI. The patients with NSTEMI more commonly experienced angina pectoris and myocardial infarction ever. The rates of chronic total occlusive lesion and triple - vessel coronary disease were increased in patients with NSTEMI than STEMI ( P 〈 0.05 ). The incidences of total occlusion of IRA in patients with NSTEMI and with STEMI were 55.2% (132/239) vs. 82, 9% (651/785) ( P 〈 0.001 ) , and the incidences of collateral circulation for IRA were respectively 57.5% ( 137/239 ) vs. 20.5% ( 161/785 ) ( P 〈 0. 001 ). Conclusion The patients with NSTEMI more commonly have risk factor, such as hypertension, diabetes, and Dyslipidemia. The severe and ex- tensive coronary arteries lesions were observed in the patients with NSTEMI. The lower incidences of total occlusion of IRA and high- er levels of collateral circulation for IRA were observed in patients with NSTEMI than in STEMI, which may account for non ST - segment elevation but ST- depression.
出处
《河北联合大学学报(医学版)》
2013年第6期754-756,共3页
Journal of North China Coal Medical College
关键词
心肌梗死梗死相关动脉冠状动脉造影
Myocardial infarction. Infarct - related artery. Coronary angiography