非ST段抬高心肌梗死的临床特点

Clinical feature and characteristics of non-ST-segment elevation myocardia infarction

目的探讨非ST段抬高心肌梗死(NSTEMI)患者的临床及冠状动脉(冠脉)病变特点,提高其诊治水平。方法对73例NSTEMI病人的临床及冠脉造影结果进行分析。结果冠心病合并高血压者50例(68%),合并糖尿病者26例(35%),高血脂者34例(46%),有吸烟史28例(38%)。既往有冠心病心绞痛者52例(71%),住院期间发生心肌梗死后心绞痛22例(30.6%)、严重心律失常15例(20.4%),心源性休克者7例(10.2%)、死亡3例(4%)。心电图ST-T下移52例(71%),大致正常2l例(29%)。冠脉造影显示≥2支血管病变54例(74%),单支血病变19例(26%),两者有显著性差异(P<0.01)。阻塞程度为95%-99%狭窄者最多,占65.8%(48/73),侧支循环形成者占26.5%(19/73)。在2-3支血管病变的54例中49例(90.7%)血管狭窄部位相互对应。结论NSTEM!病人临床症状往往较轻,住院并发症较低,但其基础病变较重,预后较差,需及时进行冠脉血运重建。

Objective To explore clinical feature and coronary arlery lesion characteristics of non-ST-segment elevation myocardial infarction（NSTEMl）. Methods Seventy--three patients of NSTEMEI were studied,their cinical data and results of coronary angiography being analyzed. Results Risk factors of coronary artery disease among al i the patients were 50（68% ）with hyperten- sion, 26 （ 35%） with diabetes, 34 （ 46 % ） with hyperlipidemia and 28 （ 38 % ） with smoking history. There were 52 （ 71 % ） with anginapectoris before this hospitalization,22（30. 6%）with in hospital angina pectoris, 15（20.4%）with severe arrythmias,7（10.2% ） with cardiac shock,3（4%）died. 52（71%）were with ST--Tdepression and 21（29%）with normal ECG. Coronary angiography revealed 54（74 % ）with lesions in more than one vessel and 19 （26 % ）in one vessel（P〈0.01 ）. The percentage with a degree of 95 % --99% stenosis was 65.8%（48/73）. Collateral circulations occurred in 26. 5% （19/73）. Of the 54 cases with 2,3 vessel lesions, 49（ 90. 7 % ）were found to have lesions at corresponding sites. Conclusion The clinics4 symptoms of NSTEMI are mild, hut coromary artery lesions are severe,and the prognosis bad. Timely reperfusion isneeded for treatment.