不稳定性心绞痛和非ST段抬高心肌梗死的临床观察

Clinical observation of unstable angina pectoris and non-ST-segment elevation myocardial infarction

目的分析不稳定性心绞痛和非ST段抬高心肌梗死的临床基本情况和治疗情况。方法选取2012年1月-2012年12月收治的UA和NSTEMI患者90例,均进行超声心动图、运动心电图、血管造影等相关检查,并根据结果进行临床病情危险性分级,并采用药物和介入方式治疗,对不同治疗方式的治疗情况(包括心绞痛改善情况;血小板聚集率和aPTT、cTnT的变化情况以及复发和死亡率)。结果介入组在心绞痛改善、血小板聚集率和aPTT、cTnT的变化上效果均更明显,且复发率和死亡率均更低,分别为7.7%和5.8%,药物治疗组发生率分别为15.8%和10.5%。结论不稳定性心绞痛和非ST段抬高心肌梗死一旦发生后应进行全面的临床检查,根据患者的检查结果进行病情危险程度分级,并采用合理的治疗方式,以改善患者的预后效果。

Objective To analyze the clinical conditions and treatment outcomes of unstable angina pectoris （UA） and non-ST-segment elevation myocardial infarction （NSTEMI）. Methods Ninety patients with UA and NSTEMI who were admitted to our hospital from January 2012 to December 2012 were included in the study. They underwent echocardiography, exercise electrocardiography, and angiography, and the grade of disease severity was determined according to the examination results. The patients were divided into medication group and interventional treatment group to receive medication and interventional treatment, respectively. The therapeutic effects were assessed according to improvement in angina pectoris, changes in platelet aggregation rate （PAR）, activated partial thromboplastin time （aVFr）, and cardiac troponin T （cTnT）, recurrence rate, and mortality rate. Results Compared with the medication group, the interventional treatment group had significantly more improvements in angina pectoris, PAR, aFTT, and cTnT and significantly lower recurrence rate and mortality rate （7.7% vs 15.8%; 5.8% vs 10.5%）. Conclusion Once UA and NSTEMI occur, comprehensive clinical examination should be performed, the disehse severity should be determined according to the examination results, and proper treatment should be adopted to improve the prognosis of patients.