摘要
目的探讨非ST段抬高急性心肌梗死(NSTEAMI)的临床特征及冠脉造影(CAG)特点,提高NSTEAMI的诊断水平,降低其漏诊及误诊率。方法将经明确诊断为NSTEAMI的45例病人及急性ST段抬高心肌梗死(STEAMI)的125例病人分为两组,对比分析两组临床及CAG特点。结果STEAMI组单支病变的比例明显高于NSTEAMI组(P<0.05),且侧支循环及慢性钙化闭塞性病病(CTO)也高于STEAMI组(P<0.01)。从临床特征上看NSTEAMI组的发病年龄较STEAMI组高(74.3岁±8.2岁与63.5岁±3.3岁),女性比例较高,静息性胸痛、心律失常及室壁运动减弱的发生率较STEAMI组低(P<0.05)。NSTEAMI组病人血中心肌损伤标记物水平较STEAMI组低(P<0.01)。结论NSTEAMI更易发生于女性病人和高龄人群,临床症状常不典形,多支病变发生率高,近期预后佳。
Objective To investigate clinical manifestation and features of coronary angiography in non- ST elevation myocardial infarction （NSTEAMI）.Methods One hundred and seventy patients （pts） were divided into two groups： NSTEMI （n =45） and STEMI （n = 125）. The dinical manifestations and coronary angiographic features were compared.Results There was 30. 4 % of STEMI pts with single-vessddisease compared 1 3 . 3 % in NSTEMI pts （ P 〈 0 . 0 5 ） . Incidence of collateral circulation and chronic obstructive calcified lesions in STEMI were higher （60.0 % and 57.8 % vs 32.8 % and 33.6 % ; P 〈 0.001 ）. Pts with NSTEMI were older （74.3 ± 8.2 vs 63.5 ± 3.3 ; P〈0. 001） and proportion of women was higher （71.1% vs 88.0% ; P〈0. 001） and resting chest pain, arrhythmia and kinesis weakened were more prevalent in pts with STEMI （46.7 %, 24.4 % and 40.0 % vs 94.4 %, 60.8 % and 62.4 % ; P 〈 0. 001 ）. Laboratory data showed that level of myocardial injury marker was lower in NSTEMI. The level of cTnT, Ck and CK - MB in NSTEAMI pts were 1.9 ± 0.2,1 465 ± 67 and 58 ± 6 respectively, and that in STEAMI 9ts were 3.6 ± 0.2,1 321 ± 116, 159 ± 9. Conclusion Female pts and elderly with NSTEAMI were more prevalent than that with STEAMI, and they often had no typical symptoms, they had higher incidence of multi-vessel disease and their prognosis was better.
出处
《中西医结合心脑血管病杂志》
2008年第3期261-263,共3页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
关键词
非ST段抬高急性心肌梗死
临床特点
冠脉造影
Non-ST- segment elevation acute myocardial infarction
clinical feature
coronary angiography
