急性心肌梗塞后心绞痛及再梗塞和梗塞延展的临床分析

The clinical analysis of angina after acute myocardial infarction and reinfarction and infarct extension

目的 分析急性心肌梗塞后心绞痛与再梗塞、梗塞延展二者的发生率、并发症、病死率及相互关系。方法 134例急性心肌梗塞(AMI)患者4周内观察其症状、体征、心电监测、心电图及心肌酶变化。结果 134例AMI患者4周内发生梗塞后心绞痛38例(28.4％),发生再梗塞和梗塞延展9例(6.7％)。梗塞后心绞痛患者发生再梗塞和梗塞延展显著多于无心绞痛患者(15.8％与3.1％,P<0.05);梗塞后心绞痛患者并发心功能不全显著多于无心绞痛患者,再梗塞和梗塞延展患者并发心功能不全及室性心律失常显著多于无再梗塞和梗塞延展患者,P<0.05;4周的病死率,在梗塞后心绞痛组及再梗塞和梗塞延展组均增加,分别为15.8％和22.2％。结论 梗塞后心绞痛是再梗塞和梗塞延展高危者;梗塞后心绞痛及再梗塞和梗塞延展的发生使并发症增加,病死率增高。

[Abstract] Objective To analysis the incidence, complication, mortality and interrelation of postinfarc-tion angina and reinfarction, infarct extension. Methods 134 patients with acute myocardial infarction (AMI) were observed their symptom , sign, electrocardio monitor, electrocardiogram and variance of myocardial enzyme for 4 weeks. Results Within 4 weeks 38 cases (28.4%) of AMI 134 patients suffered from postinfarction angina, 9 cases(6.7% ) of total suffered from reinfarction and infarct extension. The rate (15.8%) of the patients with postinfarction angina who suffered from reinfarction and infarct extension is obviously higher than that(3.1%) without angina pectoris, P <0.05; The rate of the patient with postinfarction angina complicated cardiac dysfunction is obviously higher than that without angina pectoris. The rate of the patient with reinfarction and infarct extension complicated cardiac dysfunction and ventricular arrhythmia is obviously higher than that without reinfarction and infarct extension, P <0.05; The rate of mortality in both of two groups who are postinfarction angina and reinfarction and infarct extension is increased within 4 weeks, it is 15.8% and 22.2% respectively .Conclusion Postinfarction angina is the high risk factors of reinfarction and infact extension; Postinfarction angina and reinfarction and infarct extension will cause the increasing of complication and mortality.