心肌梗死与非心肌梗死冠状动脉硬化性心脏病患者冠状动脉狭窄程度的对比及与心电图的关系

Comparison of coronary artery stricture between acute myocardial infarction and non-myocardial infarction and relation between stricture and electrocardiogram

［目的］探讨冠状动脉硬化性心脏病心肌梗死与非心肌梗死之间冠状动脉狭窄的差异，了解冠 状动脉狭窄与相应心电图变化之间的关系［方法］选用选择性冠状动脉造影证实冠状动脉不同程度狭 窄的 ４７例冠状动脉硬化性心脏病患者，分为陈旧性心肌梗死组、急性心肌梗死组、非心肌梗死组，比较 各组血管狭窄程度，观察单、双、３支病变的分布情况，组间差异均采用两率差别的显著性检验－Ｕ检 验冠状动脉狭窄程度与心电图变化之间的关系用数量的比例来表达．［结果］陈旧性心肌梗死组、急性 心肌梗死组、非心肌梗死组各组重度以上的冠状动脉狭窄各占 ７６％， ６８％， ６８％，各组间无显著性差异． 急性心肌梗死组与非心肌梗死组以非心肌梗 病变所占比重相对较高，陈旧性心肌梗死组以多支病变所占比 重相对较高．［结论］单支病变几乎是左前降支，左前降支相对应的胸前导联（Ｖ１－６）对冠状动脉病变的显 现率相对较高，与冠状动脉狭窄程度呈正相关，其余导联对冠状动脉病变的显现率相对较低，与狭窄程 度之间无规律性关系．

OBJECTIVE To discuss the difference of coronary artery stricture between acute myocardial infarction and non-myocardial infarction and to understand the relation between the coronary artery stricture and changes on electrocardiogram. METHODS Using the coronary arteriography, 47 cases of coronary heart disease were diagnosed with different degrees of stricture of the coronary artery. These patients were distributed into three groups: remote myocardial infarction. acute myocardial infarction and non-myocardial infarction. The degrees of coronary artery stricture were compared and examined the distribution of the mono-branched stricture and the multiple branched stricture were examined in three groups. Statistical significance was evaluated by using Student's U test. The relation between stricture of coronary artery and changes on electrocardiogram was evaluated by using quantitative proportion. RESULTS The degrees of exceeding serious coronary artery stricture were 76 %, 68 % and 68 % in each group, respectively. The proportion of mono-branched stricture was relatively high in the acute myocardial infarction and non-myocardial infarction and of multiple branched stricture was mainly high in the remote myocardial infarction. The mono-branched stricture was almost the left descending artery (LDA ). CONCLUSION The appearance rate of coronary heart disease was relatively high under the lead of bosom (V1-6 ) of LDA and was positively correlated with the degree of coronary artery stricture. The appearance rate of other leads is relatively low and had no regular relation with the constrictive degree.