首次急性ST段抬高与非ST段抬高心肌梗死患者临床及冠状动脉病变特征对比

First Acute ST-segment Elevation and Non-ST Segment Elevation Comparison of Clinical and Angiographic Characteristics of Patients with Myocardial Infarction

目的比较首次急性ST段抬高性与非ST段抬高性心肌梗死患者的临床特点和冠状动脉病变特征。方法方便选取2014年12月—2016年11月该院收治的50例首次急性ST段抬高性心肌梗死患者纳入甲组,并选取同期收治的另52例首次急性非ST段抬高性患者纳入乙组。对比两组患者发症及心功能,同时对两组患者行冠状动脉CT检查,比较两组冠状动脉病变特征。结果甲组心律失常、心源性休克、梗死后心绞痛、低血压发生率分别为12.00%、10.00%、16.00%、14.00%,均明显高于乙组的1.92%、0.00%、3.85%、1.92%(P<0.05);甲组心功能指标LVEF、LVEDV、LVESV、LVEDD分别为(58.72±11.35)%、(123.81±13.69)mm、(58.62±12.38)mm、(51.85±10.34)mm,与乙组的(59.31±12.06)%、(125.93±13.91)mm、(59.13±13.06)mm、(53.02±11.16)mm,差异无统计学意义(P>0.05);甲组冠状动脉病变支数为(2.06±0.68)支,明显少于乙组的(2.65±0.83)支(P<0.05);甲组侧支循环发生率为10.00%,明显低于乙组的26.92%(P<0.05)。结论首次急性ST段抬高性心肌梗死患者并发症多,冠状动脉病变相对较轻,而首次急性非ST段抬高性患首发症状类型多,且冠状动脉病变较为严重,故应针对性的给予治疗措施。

Objective Compare th e f irs t clinical features and c h a ra c te r is t ic s of coronary ar te ry dise ase with a c u te ST - se g - ment elevat ion and non-ST segment elevat ion myocardial infarction.Methods Convenient s ele ct ion a to ta l of 5 0 c a se s of a d -mit ted in December 2014 to November 2016 for the first time in pat ients with acute ST segment elevat ion myocardial infarc-tion in group A, and the other dur ing the same period were selected in 52 patients with f irst acute non ST segment elevat ion in B group. Compared two groups of pat ients with complicat ions and cardiac function at the same time, the two groups of pat ients with coronary ar tery CT examination, two group character ist ics of coronary ar tery disease.Results The ar rh ythmia, cardiogenic shock, post infarction angina pector is, the incidence of hypotension were 12.00%、 1 0 .0 0%、 1 6.00%、 1 4 .0 0% , s ignif icantly higher than that in group B 1.92%、 0 .0 0%、 3 .8 5%、 1.92% （P〈0.05）; th e c a rd ia c fu n ction indexes LVEF, LVEDV, LVESV, LVEDD respect ively（58.72±11.35）%, （1 2 3.81±1 3 .6 9）m m, （5 8.62±12.38）mm, （5 1 .85±10.34）mm, an d group B （5 9 .3 1土 12.06）% and （125.93±13.91）mm, （59.13±13.06）mm, （53.02±11.16）mm showed no signif icant dif ference（P〉0.05） ; group A （2.06±0.68）branch, signif icantly less than group B（2.65±0.83） branch（P〈0.05）; group a col lateral circulat ion rate was 10.00%, s ignif icantly lower th an th a t of group B 2 6 . 9 2 % （P 〈0.05）. Conclusion For th e f irs t time th e f irs t symptoms of a c u te ST segment e lev at io n my ocardial in fa rc tio n type less com p lic at io ns, coronary ar te ry d ise a se is re la tiv ely m ild , and th e first non-ST segment elev at io n acu te p a t ien ts with in i t ia l symptoms of many ty p e s, an d coronary ar te ry d ise a s e is more s e r io u s, it should be ta rg eted given tre a tment.