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目的通过冠状动脉造影了解急性心肌梗死患者冠脉病变特点,探讨其病变特点与发病时间关系。方法回顾分析因急性ST段抬高型心肌梗死住院行常规药物治疗,于发病2周后接受冠脉造影加支架术患者83例,根据其发病时间将患者分为二组:上午组(6:01-12:00,n=52)、其他时间组(12:01-次日06:00,n=31),由两名医师双盲进行心电图及冠状动脉造影光盘阅读和测量,结合心电图及冠脉造影明确梗死相关血管病变特点,包括部位、梗死血管病变形态、类型及狭窄程度,进行统计学分析。结果上午组、其他时间组间梗死相关血管部位差异无统计学意义(P>0.05);偏心性病变上午组较其他时间组显著多见(P<0.0125),同心型、复杂型病变二组间差异无统计学意义(P>0.0125);而血栓性病变二组间差异无统计学意义(P>0.05);A型病变上午组较其他时间组显著多见(P<0.0125),B型病变、C型病变二组间差异无统计学意义(P>0.0125);冠脉病变狭窄程度二组间差异无统计学意义(P>0.05)。结论急性心肌梗死相关血管中,A型病变及偏心狭窄病变与发病时间有关且多发生于晨起及上午。
Objective To understand the characteristics of coronary artery lesions in patients with acute myocardial infarction by coronary angiography and to explore the relationship between the characteristics of the lesions and the time of onset. Methods A retrospective analysis of 83 patients admitted to our hospital with acute ST-elevation myocardial infarction received routine medical therapy and received coronary angiography and scaffold two weeks after their onset. The patients were divided into two groups according to the onset time: morning group (6: 01-12: 00, n = 52). The other time groups (12: 01 - 06h006, n = 31) were double-blindly read and measured by two physicians on electrocardiogram and coronary angiography discs. Coronary angiography clearly infarction-related vascular lesions, including site, infarction vascular lesions morphology, type and degree of stenosis, for statistical analysis. Results There was no significant difference in the infarct-related vascular sites between the morning group and the other time groups (P> 0.05). The eccentric group was more common in the morning group than in other time groups (P <0.0125) There was no significant difference between the two groups (P> 0.0125), but there was no significant difference between the two groups in thrombotic lesions (P> 0.05) There was no significant difference between the two groups (P> 0.0125). There was no significant difference between the two groups in the degree of coronary artery stenosis (P> 0.05). Conclusions In the blood vessels related to acute myocardial infarction, type A lesions and eccentric stenosis are related to the onset time and occur mostly in morning and morning.