急性左心衰竭为首发症状的急性非ST段抬高型心肌梗死患者临床分析

Clinical analysis of non-ST-segment elevation acute myocardial infarction first presenting with a-cute left heart failure

目的：通过分析以急性左心衰竭为首发症状的急性非ST段抬高型心肌梗死（ NSTEAMI）患者的冠状动脉造影、临床特点，以提高临床诊治水平。方法分析2010年12月至2012年12月在安阳地区医院住院治疗的以急性左心衰竭为首发症状的急性心肌梗死患者的冠状动脉造影结果及临床资料。结果与急性ST段抬高型心肌梗死患者比较，以急性左心衰竭为首发症状的NSTEAMI患者的年龄大，既往多有心绞痛或心肌梗死病史，多合并有糖尿病。冠状动脉造影多为三支病变，累及左主干病变、侧支循环形成、弥漫性长病变、慢性闭塞病变的发生率高。结论以急性左心衰竭为首发心肌梗死症状的急性非ST段抬高性心肌梗死患者多合并有糖尿病，既往多有心绞痛或心肌梗死病史，冠状动脉造影多为三支病变，但急性闭塞发生率低，老年女性是此类患者的易患人群。

Objective To study the clinical features and coronary angiographic characteristics of non-ST-segment elevation acute myocardial infarction first presenting acute heart failure. Methods The clinical data and coronary angiographic results of patients with myocardial infarction first presenting the left heart failure were retrospectively analyzed. Results Compared with the STEMI group,the patients of non-ST-segment elevation acute myocardial infarction first presenting acute heart failure were elder, and most of them had myocardial infarction history,angina,accompanied with diabetes mellitus. The incidence of three vessel disease,left main artery disease,branch cycle formed,diffuse disease,chronic obliterated disease was more higher. Conclusions Among the patients of non-ST-segment elevation acute myocardial infarction first presenting acute heart failure,most of them had myocardial infarction history,angina,accompanied with diabetes mellitus. Coronary artery diseases are mostly severe and multi-ple,but the incidence of acute obliteration is low. And senile female are susceptible population.