梗死前心绞痛在未行血运重建的急性心肌梗死患者中的临床意义

The clinical significance of pre-infarction angina in acute myocardial in farction patients who have not received revascularization

目的探讨在未行血运重建的急性心肌梗死患者中有无梗死前心绞痛对患者预后是否有影响。方法将未能及时行急诊再灌注治疗且后期因各种原因未能行择期PCI或CABG术的122例AMI患者分为梗死前心绞痛组(A组)和无梗死前心绞痛组(B组),比较两组QRS积分、心肌酶学峰值、LVEF及起病1个月内病死率情况。结果 A组QRS积分、心肌酶学峰值及起病1个月内病死率明显低于B组(P<0.05),但A组LVEF明显高于B组(P<0.05)。结论梗死前心绞痛可以对心梗患者心肌产生保护作用,从而在其后发生AMI时能减轻心肌损伤,对其预后有益。通过询问AMI前有无心绞痛发作史,对判断患者预后有参考价值。

Objective To explore the possibility of effect on patients＇ prognosis that whether or not acute myocardial infarction （AMI） patients who have not received revascularization treatment have suffered from pre-infarction angina. Methods 122 AMI patients who failed to receive emergency reperfusion therapy and later missed elective percutaneous coronary intervention （PCI）or coronary artery bypass grafting （CABG）for various reasons,were divided into pre-infarction angina group （Group A）and non-pre-infarction angina group （Group B）. The QRS score, myocardial enzymology peak,left ventricular ejection fraction （LVEF） and case-fatality rate within one month since onset of the disease were compared. Results The patients in Group A were significantly lower than those in Group B（P 〈 0.05）in QRS score,myocardial enzymology peak,and case-fatality rate within one month since onset of the disease, while significantly higher than those in Group B （P 〈 0.05） in LVEF. Conclusion Pre-infarction angina can protect the myocardium of patients with myocardial infarction and relieve the damages incurred by later onset of AMI, be beneficial to their prognosis. The inquiry of whether patients have ever suffered angina before the onset of AMI can be used as reference for judgment of the patients＇ prognosis.