摘要
目的:总结冠状动脉痉挛导致急性心肌梗死的临床特点及诊治经验。方法:回顾性分析2014年3月至2019年6月期间收治的12例冠状动脉痉挛致急性心肌梗死患者的临床资料。结果:冠状动脉痉挛导致急性心肌梗死患者经冠状动脉造影、血管内超声、光学相干断层扫描检查呈现多种表现形式,其中右冠状动脉痉挛急性下壁心肌梗死8例(66. 7%),左前降支痉挛急性前壁心肌梗死2例(16. 7%),右冠、左前降支及左回旋支痉挛急性下壁合并前壁心肌梗死2例(16. 6%)。术中经冠状动脉内给予硝酸甘油后冠状动脉痉挛均消失,术后经硝酸酯类、钙离子拮抗剂及他汀药物等治疗后,患者胸闷、胸痛临床症状缓解。结论:冠状动脉造影及血管内超声、光学相干断层扫描能够及时明确诊断冠状动脉痉挛导致的急性心肌梗死,并有效地指导药物治疗,临床上硝酸酯类加钙离子拮抗剂药物治疗冠状动脉痉挛效果显著。
Objective:To summarize the clinical experience of diagnosis and treatment of acute myocardial infarction caused by coronary artery spasm.Methods:A retrospective analysis of 12 patients with acute myocardial infarction who underwent coronary artery spasm from March 2014 to June 2019 was performed.Results:Through coronary angiography and intravascular ultrasound(IVUS)or optical coherence tomography(OCT),the diagnosis of different coronary artery spasm was confirmed.Eight patients(66.7%)of acute inferior myocardial infarction caused by right coronary artery spasm,2 patients(16.7%)of acute anterior myocardial infarction caused by the left anterior descending coronary artery spasm,2 patients(16.6%)of acute anterior and inferior myocardial infarction caused by three coronary arteryies spasm.The coronary artery spasm was disappeared after intracoronary administration of nitroglycerin.After treatment with nitrates,calcium antagonists and statins,the clinical symptoms of chest tightness and chest pain were relieved.Conclusion:Coronary angiography,IVUS and OCT can be used to diagnose acute myocardial infarction caused by coronary artery spasm and guide drug treatment effectively.The clinical effect of nitrate drugs and calcium antagonist drugs is significant.
作者
袁伟
仲建军
李卫东
陈小节
严金川
YUAN Wei;ZHONG Jian-jun;LI Wei-dong;CHEN Xiao-jie;YAN Jin-chuan(Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu 212001,China)
出处
《江苏大学学报（医学版）》
CAS
2019年第6期499-501,共3页
Journal of Jiangsu University：Medicine Edition
基金
江苏省六大人才高峰项目(WSN-045)
江苏省青年医学人才项目(QNRC2016843)
江苏省社会发展基金资助项目(BE2017699)
关键词
冠状动脉痉挛
冠状动脉造影
急性心肌梗死
coronary artery spasm
coronary angiography
acute myocardial infarction
