STEMI与NSTEMI冠状动脉血栓病理特征的研究

Study of pathological characteristics of coronary artery thrombus in STEMI and NSTEMI

目的:研究比较ST段抬高型心肌梗死(STEMI)与非ST段抬高型急性心肌梗死(NSTEMI)患者冠状动脉血栓的病理特征。方法:依据心电图检测结果,于我院治疗的156例急性心肌梗死(AMI)患者被分为STEMI组(78例)和NSTEMI组(78例),观察比较两组冠状动脉造影结果及血栓病理检查结果。结果:与NSTEMI组比较,STEMI组冠状动脉多支病变比例(62.82%比37.18%)、远端冠脉梗死比例(39.74%比17.95%)、白色血栓比例(71.79%比21.79%)均显著降低,近端冠脉梗死比例(25.64%比52.56%)、红色/混合血栓比例(28.21%比78.21%)均显著升高(P均<0.01)。结论:STEMI冠脉血栓多为红色/混合血栓,NSTEMI患者冠脉血栓多为白色血栓,且STEMI患者冠脉梗死部位多为单支病变和冠脉近端病变,病情更急。

Objective:To study and compare pathological characteristics of coronary artery thrombus between ST segment elevation myocardial infarction(STEMI)and non ST segment elevation acute myocardial infarction(NSTEMI).Methods:According to results of electrocardiogram,a total of 156 patients with acute myocardial infarction(AMI)treated in our hospital were divided into STEMI group(n=78)and NSTEMI group(n=78).The results of coronary angiography and thrombus pathology were observed and compared between two groups.Results:Compared with NSTEMI group,there were significant reductions in percentages of multivessel coronary disease(62.82%vs.37.18%),distal coronary infarction(39.74%vs.17.95%),and white thrombus(71.79%vs.21.79%),and significant rise in proximal coronary artery infarction(25.64%vs.52.56%),and red/mixed thrombus(28.21%vs.78.21%)in STEMI group(P<0.01 all).Conclusion:Coronary thrombus in STEMI is mostly red/mixed thrombus,while it is mostly white thrombus in NSTEMI patients.Coronary artery infarction is mostly at the single vessel disease and proximal end of coronary artery,the severity of infarction is more urgent in STEMI patients.