急诊PTCA心肌梗塞患者侧支循环与临床特征的研究

The relationship between collaterals and clinical features in patients with acute myocardial infarction undergone emergent PTCA

目的 :探讨急性心肌梗塞患者临床特征与冠脉支循环之间的关系。方法 :12 5例急性心肌梗塞患者根据造影结果分为A、B两组。A组包括 5 3例患者 ,侧支循环Rentrop分级 2级或 3级 ;B组包括 72例患者 ,侧支循环Rentrop分级 0级或 1级。对术前术后临床变化作统计学分析。结果 :侧支循环分级与冠脉病变部位数量无关。结论 :异常Q波出现 ,ST段抬高及心肌酶水平升高常提示侧支循环不良 ;心绞痛病程大于 3个月是影响侧支循环分级的独立因素 ;良好的侧支循环对梗塞后心室肌有保护作用 ,有利于左室功能的恢复。

Objective To investigate the relationship between clinical features of patients with acute myocardial infarction(AMI) and coronary collaterals.Method One hundred and twenty-five patients with AMI were divided into group A and B according to the results of angiogram. Group A included 53 patients whose collateral Rentrop classification was 2 or 3,and group B included 72 patients whose Rentrop classification was 0 or 1.Clinical changes pro and post intervention were statistically analysed.Results collateral classification was unrelated to the number of lesions and lesion sites.Conclusions Abnormal Q waves,elevated ST segment and myocardial enzymes implies underdeveloped collaterals pro AMI.History of angina pectoris(AP) more than 3 months is an independent factor that affects the development of collaterals.A well-developed collaterals pose a protective function to infarcted myocardium and is helpful for recovery of left ventricular function after AMI