创伤后心肌梗死的临床特点与预后随访

The Clinical Characteristics and Prognosis of Post-traumatic Myocardial Infarction

目的通过对我院收治的因胸部钝性创伤导致心肌梗死的患者进行病例回顾及随访,探讨创伤后心肌梗死患者的临床特点和预后情况。方法选择阜外医院1999年至今收治的8例创伤后心肌梗死患者,分析其病因、冠状动脉造影结果及心功能,并收集门诊、住院复查资料或电话随访,评价主要心脏不良事件发生情况。结果入选患者均为男性,7例为青年,因车祸伤、击打伤及摔伤诱发,冠脉病变7例为单支病变,1例正常,6例有心功能下降,随访距出院时间0.5-6年,有2例出现主要心脏不良事件,为心功能不全、室壁瘤形成。结论创伤后心肌梗死患者多见于青年,由钝性伤诱发,冠状动脉以单支病变或正常为主,可有心功能下降,患者的预后主要取决于心肌梗死发生后心功能情况,其主要心脏不良事件以心功能不全、室壁瘤形成为主。

Objective To explore the clinical characteristics and prognosis of patients with post-traumatic myocardial infarction. Methods 8 patients were admitted to Fuwai Hospital after post-traumatic myocardial caused by blunt chest trauma since 1999. The in-patient case history were reviewed to analyze the causes, coronary anglography results and cardiac function evaluation, and telephone follow-up, outpatient medical record and rehospitalizatiun histoxy were collected to evaluate the major adverse cardiac events. Results Selected patients were male, 7 cases are youth. The causes are traffic accident injmy, blunt hitting and hurt. The coronsry artery lesions are mainly of single vessel（7 are single vessel affected, l is normal）.6 of them show cardiac dysfunction.With 0.5-6 years follow-up, there are 2 cases of major adverse cardiac events, including ejection dysfunction and ventricutar aneurysm formation. Conclusion Post-traumatic myocardial infarction are more common in the youth caused by blunt injury, with a single lesion or normal coronary arteries. Sometimes the ejection fraction may be affected. The prognosis of patients mainly depends on the cardiac output function after myocardial infarction, which ejection dysfunction and ventricular anenrysm formation are the most common major adverse cardiac events.