急性心肌梗死后早期心绞痛临床分析

Early clinical analysis of angina after acute myocardial infarction

目的：探讨急性心肌梗死后早期心绞痛发生的相关因素，为其临床防治措施的制定提供依据。方法选取急性心肌梗死患者132例，收集纳入患者的各项临床资料，统计急性心肌梗死后早期心绞痛的发生率及其临床特点，同时对比发生急性心肌梗死后心绞痛和未发生急性心肌梗死后心绞痛患者的临床资料，探讨急性心肌梗死早期心绞痛发病的相关因素。结果急性心肌梗死后早期心绞痛发生率为29．55％。其中在急性心肌梗死后7 d 内发生心绞痛的概率最高，占64．10％，其次为7～14 d 内发生心绞痛，占28．21％。34例为原心肌梗死部位缺血，5例表现为远部位缺血，21例表现为 ST 段抬高，18例表现为 ST 段缺血型下移。前壁、下壁复合梗死、溶栓治疗成功再通、心肌梗死前有心绞痛发作、有高血压病史、心功能分级≥Ⅲ级的患者发生急性心肌梗死后早期心绞痛的比例显著增高（均 P ＜0．05）。结论前壁、下壁复合梗死、溶栓治疗成功再通、心肌梗死前有心绞痛发作、有高血压病史、心功能分级≥Ⅲ级和急性心肌梗死后早期心绞痛的发生相关，临床应积极采取针对性的措施，及早预防和治疗急性心肌梗死后早期心绞痛，以避免病情的加重，改善患者的预后。

Objective To investigate the related factors of early angina after acute myocardial infarction,and to provide basis for the disease prevention and control.Methods 1 32 cases with acute myocardial infarction were selected.The clinical data were collected.The occurrence rate of early angina pectoris after acute myocardial infarc-tion,and clinical characteristics were analyzed.The related factors of acute myocardial infarction angina were explored.Results The incidence rate of early angina pectoris after acute myocardial infarction was 29.55%.Within 7 days after acute myocardial infarction occurred angina,the highest rate for 64.1 0%,followed by 7 -1 4 days in the occurrence of angina pectoris,28.21 %.34 cases were the original location of myocardial infarction ischemia and 5 cases were the far part of ischemia,21 cases showed ST segment elevation,1 8 cases showed ST lack blood group downward.Anterior wall,inferior wall infarction composite,successful thrombolytic therapy recanalization,myocardial infarction before episodes of angina pectoris,history of hypertension,heart function classification more than or equal to grade III in patients with acute myocardial infarction occurred after the proportion of early angina pectoris were signifi-cantly higher （all P 〈0.05）.Conclusion Anterior wall,inferior wall infarction composite,successful thrombolytic therapy recanalization,myocardial infarction before episodes of angina pectoris,history of hypertension and cardiac functional grading more than or equal to grade III are related to early angina pectoris after acute myocardial infarction. We should actively take measures aimed at early prevention and treatment of early angina pectoris after acute myocar-dial infarction to avoid illness aggravating,improve the patients＆#39;prognosis.