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目的 :了解急性心梗患者梗塞相关冠脉血管病变情况 ,以期明确国内急性心梗患者冠脉病变特点 ,为临床防治提供较客观的依据。方法 :从 1993年至 1997年接受冠脉造影的患者中选取在心梗急性期 (30天 )内冠造者 ,对其冠造显示的冠脉病变部位、程度及相关因素进行分析。结果 :10 4例患者纳入观察范围。年龄 2 8～ 74岁 ,平均 5 4 1± 11 4岁 ,其中男 88例 ,女 16例 ;梗塞相关冠脉狭窄程度平均为 83 3%± 16 5 % (30 %～ 10 0 % ) ,其中病变直径狭窄 <5 0 %者 5例 (4 8% ) ,5 0 %～ 6 9%者 15例(14 3% ) ,70 %～ 89%者 2 6例 (2 5 % ) ,90 %～ 99%者 35例 (33 6 % ) ,完全闭塞 (10 0 % )者 2 3例 (2 2 1% ) ;病变累及LAD者 5 3例 (5 1 0 % ) ,累及RCA者 4 2例 (40 4 % ) ,累及LCX者 9例 (8 7% ) ;纳入TUCC研究的 15例患者中LAD 10例 ,RCA4例 ,LCX 1例 ,其平均狭窄程度 92 7% (70 %～ 10 0 % )。结论 :AMI者急性期冠造仍显示有较严重的冠脉病变 ,相当一部分仍完全闭塞 ,可能与未溶栓或溶栓效果欠佳有关 ,提示应考虑急诊或补救性PTCA及冠脉支架治疗以争取较好预后
Objective: To understand the infarction-related coronary artery disease in patients with acute myocardial infarction in order to clarify the characteristics of coronary lesions in patients with acute myocardial infarction in China, to provide more objective evidence for clinical prevention and treatment. Methods: From 1993 to 1997 in patients undergoing coronary angiography in the acute myocardial infarction (30 days) in the selection of coronary artery disease, coronary artery lesions showed its location, degree and related factors were analyzed. Results: 104 patients were included in the observation range. The mean age of patients with coronary artery stenosis was 83.3% ± 16.5% (30% ~ 100%), of which 28 were male and 16 were female, with an average age of 541 ± 114 years Fifty-five (48%) of the patients had stenosis of diameter less than 50%, 15 (14.3%) were from 50% to 69%, 26 (25%) and 90% 35 (33.6%) were found in 99% of the patients, 23 (21.2%) of the patients were completely occluded (100%), 53 10 cases of LAD, 4 cases of RCA and 1 case of LCX were enrolled in the TUCC study. The average degree of stenosis was 92.7% (70% ~ 100%) in 40 cases of LCX. . Conclusion: AMI patients with acute coronary artery still showed more severe coronary lesions, a considerable part of the total occlusion may not be thrombolytic or thrombolytic effect is poor, suggesting that emergency or remedial PTCA and coronary stent treatment should be considered To strive for a better prognosis