STEMI与NSTE-ACS的临床特征及冠状动脉病变特点比较

Comparison of Clinical Features and Coronary Artery Lesion Characteristics between STEMI and NSTE-ACS

目的:探讨急性ST段抬高型心肌梗死(STEMI)与非ST段抬高型急性冠状动脉综合征(NSTE-ACS)临床特征及冠状动脉病变特点。方法:146名行急诊冠脉介入治疗(PCI)患者分为STEMI组(112名)和NSTE-ACS组(34名)。观察两组患者基线临床特点及冠脉病变特征。结果:两组患者的性别、年龄、住院时间、既往病史、差异均无统计学意义。冠心病危险因素中吸烟史STEMI组较NSTE-ACS组有增多趋势(P=0.076)。STEMI组白细胞较NSTE-ACS组明显升高(P=0.041)。冠脉病变STEMI组罪犯血管为左回旋支(LCX)的显著少于NSTE-ACS组,但右冠状动脉(RCA)的更多见(P=0.011),STEMI组造影发现血栓显著多于NSTE-ACS组(P=0.014)。两组在其余病变特点差异均无显著性。结论:STEMI患者较NSTE-ACS更多伴有吸烟史,入院时白细胞更高,LCX的显著少于NSTE-ACS组,RCA的更多。行急诊PCI时STEMI组造影血栓更多见。

Objective： To investigate the clinical characteristics of acute ST segment elevation myocardial infarction（STEMI） and non ST segment elevation acute coronary syndrome（NSTE-ACS） and the characteristics of coronary artery disease. Methods： 146 patients with emergency percutaneous coronary intervention（PCI） were divided into group AMI（112） and group NSTE-ACS（34 patients）. The clinical characteristics and coronary artery lesion characteristics were observed in the two groups. Results：There were no significant differences in gender, age, length of stay, past medical history between the two groups. The risk factor, smoking history, might be an indicatorfor the STEMI compared with the NSTE-ACS（P=0.076）. The white blood cell in the STEMI group was significantly higher than that of the NSTE-ACS group（P=0.041）. The left circumflex artery（LCX）,which is a culprit artery, caused more NSTE-ACS than STEMI; however, the dysfunction of right coronary artery（RCA） was more common（P=0.011） than the LCX.in the STEMI group.It was shown in the angiography, thrombosis in the group STEMI was significantly higher than that in the group NSTE-ACS（P=0.014）. There was no significant difference between the two groups in the other pathological changes. Conclusion： Smoking history, as well as the increased white blood cells at admission stage,is more common in the group STEMI patients than that in the group NSTE-ACS. The dysfunction of LCX lead more NSTE-ACS, and that of RCA lead more STEMI, while thrombosis is much often seen in the STEMI group from the angiography.