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我院近年收治AMI中有30例急性期发生梗塞面积扩大,分析如下。 1 临床资料 1.1 一般资料 20例中男28例,女2例,年龄60～79岁,平均年龄65.5岁 1.2 诊断依据 根据WHO的AMI诊断标准,并在急性期出现心绞痛、急性左心衰、心源性休克、酶学改变、ECG梗塞面积扩大, 1.3 面积扩大原因 30例中3例有明确诱因,情绪波动,其余无明确诱因。 1.4 梗塞扩大部位、时间及酶学改变 7例心梗后36小时至6天内原来是梗塞图形的导联ST段又抬高,相邻的导联无qR型,ST段也抬高。如1例原V_1～V_4是梗塞图形,6小时后降至正常的ST段又抬高,V_6呈qR型,ST段抬高。 15例心梗后30～70小时内与原梗塞区同一血管供血的近端相邻分支供血区发生梗塞,如1例原是Ⅱ、Ⅲ、avF梗塞图形,70小时后V_7～V_9出现梗塞图形。
In our hospital admitted to AMI in recent 30 cases of acute infarction area expansion, the analysis is as follows. 1 Clinical data 1.1 General Information 20 cases of male 28 cases, 2 females, aged 60 to 79 years, mean age 65.5 years old 1.2 Diagnosis According to WHO diagnostic criteria for AMI, and in the acute phase of angina pectoris, acute left heart failure, heart Source shock, enzymatic changes, ECG infarct size, 1.3 area expansion reasons 30 cases in 3 cases have a clear incentive, mood swings, the rest without clear incentive. 1.4 infarction to expand the site, time and enzymatic changes in 7 cases of myocardial infarction 36 hours to 6 days after the original infarction pattern leads ST segment and elevation, the adjacent lead without qR type, ST segment elevation. For example, the original V_1 ~ V_4 is an infarction pattern. After 6 hours, the ST segment is elevated to normal again. The V_6 is qR type and the ST segment is elevated. 15 cases of myocardial infarction within 30 to 70 hours and the same infarct area of the same blood supply to the proximal adjacent artery infarction, such as 1 case was the original Ⅱ, Ⅲ, avF infarction pattern, 70 hours after V_7 ~ V_9 infarction pattern .