急性心肌梗塞的扩展

Acute Myocardial Infarction Expansion

本文就北京医院历年来心肌梗塞83例的尸检材料,对其中66例进行了分析,从病理形态学角度探讨心肌梗塞的扩展方式及发生机制。尸检证实心肌梗塞的范围越大,丧失的心肌越多,并发症和死亡率越高。因此应尽量使心肌梗塞局限化,防止心肌梗塞不断扩大,这是降低死亡率、提高治愈率的重要环节。

Myocardial infarction expansion refers to the occurrence of fresh infarction at the periphery of an acute myocardial infarction or at another site or sites not previously infarcted. In our 66 cases of acute myocardial infarction, 21 cases (31.8%) showed local expansion. In these 21 cases, 52.4% revealed only one branch of the coronary artery system which showed grade Ⅲ lumen narrowing. In 45 cases (68.2%), besides the local expansion, there was focal expansion at other sites. Among these 45 cases, 83.3% showed two or more branches of the coronary artery system had grade Ⅲ lumen narrowing. There was pump failure in 52.4% of these cases. The pattern of the development of these two types of myocardial expansion is discussed.