急性心肌梗死患者再入院时冠状动脉造影特点分析

Analysis of coronary angiography in patients with acute myocardial infarction after re-admission

目的分析急性心肌梗死患者再入院的冠状动脉(冠脉)造影特点,探讨再入院原因。方法入选2015年1月1日~2016年12月20日于徐州医科大学附属医院收治的既往因急性心肌梗死行急诊经皮冠脉造影(PCI)术后再入院患者,记录再入院时间,比较两次造影特点,包括病变血管数,狭窄位置,狭窄程度,根据血管病变是否进展及是否需要PCI治疗将患者分成3组,评估病变血管数与冠心病危险因素控制情况的关系。结果患者再入院的时间高峰为出院后1月,占31.25%。1年时出现小高峰,占14.58%。第二次造影结果提示79.17%的患者仍存在冠脉狭窄,其中10.53%的患者出现支架内狭窄,且初次病变血管数量越多,血脂水平控制越好。结论急性心肌梗死PCI术后的患者,常于术后1月出现不适症状,造影结果提示多由原有的非梗死相关血管狭窄病变引起。

Objective To analyze the characteristics of coronary angiography in patients with acute myocardial infarction（AMI） and to explore the causes of rehospitalization. Methods From January 2015 to December 2016, 48 re-hospitalized patients with AMI after receiving percutaneous coronary intervention（PCI） were selected. The time of re-admission was recorded. The number of diseased vessels, the location of stenosis and the degree of stenosis were compared. Patients were divided into three groups according to the condition of vascular disease and whether PCI was needed to assess the relationship between the number of diseased vessels and the control of coronary heart disease risk factors. Results Most of the patients（31.25%） were re-admitted 1 month after discharge, 14.58% patients were re-admitted 1 year after discharge. The results of the second angiography suggest that 79.17% of patients still have coronary artery stenosis, of which 10.53% of patients with stent stenosis. With the larger number of primary lesions of blood vessels, blood lipid levels are better controlled. Conclusion In AMI patients underwent PCI, most of the symptoms occurred within 1 month after discharge, and the result showed that the stenosis was caused by the original non-infarct related vessels.