无Q波型与Q波型心肌梗塞临床对比研究

COMPARISON OF CLINICAL FEATURES OF NON-Q-WAVE AND Q-WAVE MYOCARDIAL INFARCTION

对比研究了50例无Q波型急性心肌梗塞(NQMI)和60例Q波型急性心肌梗塞(QMI)的临床特点。NQMI病人有心绞痛史、陈旧性心肌梗塞史者较多,而有室壁瘤者较少,血清肌酸磷酸激酶(CPK)及其同功酶(CPK-MB)峰值(分别为325.6±247.9,20.9±10.7Iu/L)较QMI(分别为140.7±1098.2,56.1±38.5Iu/L)低,差异有高度显著性(P<0.01),恢复期左心室射血分数(0.52±0.07)较QMI(0.43±0.14)高,差异有显著性(P<0.05),提示其梗塞面积较小。冠状动脉造影显示NQMI病人三支病变者(57.1％)较QMI(22.5％)多,而单支病变者(14.3％)较QMI(51.6％)少,差异均有显著性(P<0.05)。

The clinical features of 50 patients with acute non-Q-wave myocardial infarction(NQMI) were studied, in comparison with those of 60 patient with acute Q-wave myocardial infarction(QMI). The patients with NQMI had a higher incidence of preinfarction angina(60.0% vs, 36.7%) and previons myocardial infaction(28.0% vs 6.7%), but had alower incidence of ventricular aneurysm(2.0% vs 20.0%) than those with QMI. They also had a smaller infarct size thich was estimated by CPK top values(325.6±247.9 vs. 1407.2±1098.2IU/L), CPK-MB top values (20.9±10.7 vs, 56.8±38.6IU/L)and LVEF levels(convalescence, 0.52±0.07 vs, 0.43±0.14). Coronary arteiography had shown that, for the patients with NQMI, the ratio of triple-vessel disease was higher(57.1% vs 22.5%), while the ratio of single-vessel disease was lower(14.3% vs, 51.6%)