急性心肌梗死后早期心绞痛的临床特点及分析

Clinical Features and Analysis of Early Post-infarction Angina

151例急性心肌梗死患者中有57例(37.75％)发生梗死后早期心绞痛。该组病人伴心绞痛史、高血压史、陈旧心肌梗死史者明显高于无梗塞后早期心绞痛组(P<0.05)。梗死后心绞痛在静息下发作者占50.88％,轻微活动状态发作者占29.82％,在静息或轻微活动均有发作者占19.30％。多数初次发作于第1周内(64.91％),少数发作于梗塞后第2周内(35.09％)。41例患者接受冠脉造影检查,多支血管病变病人梗死后心绞痛和恶性室性心律失常发生率显著高于单支血管病变组(P<0.05)。结果提示,梗死后早期心绞痛患者可能仍然存在心肌缺血,常为多支冠脉血管病变,顶后差,应予以重视。

57(37. 75%)patients with early post-infarction angina (PIA) of 151 patients with AMI were studied. Incidence of previous angina,hypertension and old myocardial infarction in the early PIA group was higher than non-PIA group(P<0. 05). These patients felt angina during rest(50. 88% ) ,slight exercis-es(29. 82%),both of rest and slight exercises(19. 30%). PIA in most patients(64. 91%)occured in the first week,but less(35. 09%)in the second week. 41 patients of all patients underwent the angiogra-phy. Incidences of PIA and threatening ventricular arrhythmia in multi-vessel disease group were higher than single-vessel disease group(P<0. 05). The results showed that patients with early PIA may present myocardial ischemia and multi-vessel disease of the coronary arteries. The prognosis was worse, so these patients needed to be paid attention to the management.