急性多部位心肌梗死心电图与冠状动脉造影相关研究

Relationship between electrocardiographic features and angiographic findings in patients with a first multiple acute myocardial infarction

３７例心电图确诊为急性多部位心肌梗死（ＡＭＩ）患者，前壁＋下壁或侧壁ＡＭＩ２３例（甲组），下壁＋侧壁或后壁ＡＭＩ１４例（乙组）。冠状动脉（冠脉）造影示单支血管病变甲组１７例（均为左前降支病变），乙组９例（其中右冠脉病变７例，回旋支病变２例）；多支血管病变甲组６例和乙组５例。甲组左心室室壁活动异常积分、临床心功能分级及死亡率均显著高于乙组（Ｐ＜０．０５）。但单支血管病变患者与多支血管病变患者的左心室功能及心脏事件发生率无显著差异。因此，首次多部位ＡＭＩ时，单支血管病变多见，且在累及前壁时，常由左前降支病变引起，同时临床预后较差。

linical and angiographic findings were retrospectively analysed in 37 patients with an electrocardiographically-documented first multiple sites of actue myocardial infarction(AMI).23 patients had anterior+inferior or lateral AMI(group I),and 14 experienced inferior+lateral or posterior AMI(group Ⅱ).Cornary arteriography revealed single vessel disease in 17 patients in group I(all had left anterior descending artery disease) and in 9 patients in group Ⅱ(7 had right coronary artery disease and 2 had left circumflex artery disease).Multivessel disease was observed in 6 patients in group I and in 5 patients in group Ⅱ,respectively.Clinical functional class (NYHA),left ventricular regional wall motion abnormality score and total mortality were higher in group I than in group Ⅱ (P<005).However,there was no significant difference in clinical functional class and cardiac event rate between patients with single vessel disease and those with multivessel disease.Thus,in patients with a first multiple AMI,single vessel disease was common,and when anterior wall of the left ventricle was involved,the patient often had left anterior descending artery disese and poor clinical outcome.