非ST段抬高型急性心肌梗死临床特点分析

Clinical Features of Non-ST-segment Elevation Acute Myocardial Infarction

目的探讨非ST段抬高型急性心肌梗死的临床特点,提高对其认识。方法我院心血管内科2010年1月—2014年10月收治符合纳入排除标准的急性心肌梗死120例,根据心电图检查提示有无ST段抬高分为非ST段抬高组及ST段抬高组两组各60例。采用回顾性分析研究,记录比较两组一般资料、冠状动脉数字减影血管造影(DSA)检查情况及住院期间、随访1年不良事件发生情况。结果非ST段抬高组年龄高于ST段抬高组,女性、体重指数≥25 kg/m2者多于ST段抬高组,糖尿病、心绞痛、陈旧性心肌梗死发生率均高于ST段抬高组,差异均具有统计学意义(P<0.05);冠状动脉DSA检查结果显示冠状动脉多支病变率、高度狭窄率亦明显高于ST段抬高组,差异亦均具有统计学意义(P<0.05)。非ST段抬高组住院期间再梗死率、再发心绞痛率、病死率及随访1年再梗死率、再发心绞痛率均明显高于ST段抬高组,随访1年病死率低于ST段抬高组,差异均具有统计学意义(P<0.05)。结论非ST段抬高型急性心肌梗死多发于高龄、女性、体重指数≥25 kg/m2及有糖尿病、心绞痛、陈旧性心肌梗死患者,且多伴多支冠状动脉病变,冠状动脉高度狭窄比例较高。注意对此类患者进行健康教育,并指导其控制血糖、体重,可在一定程度上降低非ST段抬高型急性心肌梗死发生率。

Objective To explore the clinical features of non-ST-segment elevation acute myocardial infarction （ NSTEAMI） . Methods 120 patients with acute myocardial infarction admitted during January 2010 and October 2014 to our hospital were divided into two groups according to the ST-segment of electrocardiogram, NSTEMI group and ST-segment eleva-tion myocardial infarction （ STEMI） group, each with 60 cases. Retrospective analysis was made between two groups with gen-eral information, DSA result, and adverse events in hospitalization stay and one-year follow-up. Results Old age, female gender, BMI index （≥25 kg/m^2 ） , complications with diabetes, angina and old myocardial infarction of NSTEMI group were higher than those of STEMI group, with significant difference between NSTEMI and STEMI groups （P〈0. 05）. The rates of multivessel coronary artery disease and heavy stenosis of carotid artery of NSTEMI group were higher than those of STEMI groups by DSA examination （P〈0. 05）. The rates of re-infarction, recurrence rate of angina pectoris, mortality rate, hospital stay and rates of re-infarction, recurrence rate of angina pectoris after one-year follow-up of NSTEMI group were higher than the rates of STEMI groups, and the rate of mortality after one-year follow-up was lower than that of the STEMI groups （ P〈0. 05）. Conclusion Older age, female gender, BMI index≥25 kg/m^2, complications with diabetes, angina and old myocar-dial infarction are risk factors of NSTEAMI. The rates of multivessel coronary artery disease and heavy stenosis of carotid artery are high in patients with NSTEMI. Health education and guided control of blood sugar and weight can reduce the incidence rate of NSTEMI patients to a certain degree.