冠状动脉侧支循环在急性心肌梗死远期预后中的价值探讨

To Explore the value of the collateral circulation for the long term prognosis in acute myocardial infarction.

目的 :探讨冠状动脉侧支循环在急性心肌梗死远期预后中的价值。方法 :对 70例急性心肌梗死患者行冠状动脉造影及三年随访资料分析研究。结果 :3 6例侧支积分 >1(CC组 =有侧支循环 ) ,3 4例侧支积分 =0 (NCC组 =无侧支循环 ) ,两组比较 ,CC组的多支 (双支以上 )病变率较高 (P <0 0 1) ,NCC组的单支病变率较高 (P <0 0 1)。两组冠脉狭窄、迂曲、钙化程度相似(P >0 0 5 )。随访发现 ,CC组前两年内心功能优于NCC组 ,心绞痛及再梗率低于NCC组 (P <0 0 1) ,无病死者。但两组心梗后第三年预后相似 (P >0 0 5 )。结论 :侧支循环对心肌梗死急性期及心梗后两年内有重要保护作用 。

Objective:To explore the value of collateral circulation for the long term prognosis in acute myocardial infarction.Methods:seventy patients with acute myocardial infarction were studied.To study the results of coronary angiography and long term follow up.Results:Integration of 36 cases collateral circulation>1(CCygroup),the integration of 34 cases collateral circulation=0(NCC group).Compared within two groups,the rate of multiple branchs affection in CC group is higher,but no difference were observed between two groups on winding stenosis and calcification.By follow up in two years the heart function of CC group is better than NCC group,dead rate is lower(P<0 01),but in third year there is no different in prognosis.Conclusion:The collateral circulation plays important protective function for acute myocardial infarction and post myocardial infarction within two years,but in third year will no protective funcrion.