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目的分析急性下壁、后壁、右室心肌梗死梗死相关动脉造影特点。方法收集并总结我院2002年6月至2009年10月明确诊断为急性下壁、后壁、右室心肌梗死并接受冠状动脉造影的患者124例,分析梗死相关动脉特点。结果 1、梗死相关动脉血管:右冠状动脉(RCA)103例,占83.1%,左前降支(LAD)4例,占3.2%,左回旋支(LCX)17例,占13.7%;2、梗死相关动脉病变部位:近段75例,占60.5%,中段29例,占23.4%,远段20例,占16.1%;3、病变狭窄程度:狭窄50%～75%15例,占12.1%,狭窄75%-99%31例,占25.0%,100%闭塞病变78例,占62.9%;4、病变性质:血栓病变103例,占83.1%。结论急性下壁、后壁、右室心肌梗死患者梗死相关动脉:(1)以右冠状动脉血管病变为主,其次为左回旋支,极少病例为左前降支病变;(2)下壁心梗、下后壁心肌梗死梗死相关动脉为左前降支或左回旋支者中段、远段病变稍多而梗死相关动脉为右冠状动脉病变者近段、中段病变稍多,右室心肌梗死患者均为右冠近段病变;(3)闭塞病变多;(4)血栓性病变多。
Objective To analyze the characteristics of infarction-related arteriography in acute inferior wall, posterior wall and right ventricular myocardial infarction. Methods 124 patients with acute inferior wall, posterior wall, right ventricular infarction and coronary angiography diagnosed in our hospital from June 2002 to October 2009 were collected and summarized, and the characteristics of infarct-related arteries were analyzed. Infarction-related artery: 103 cases of right coronary artery (RCA), accounting for 83.1%, 4 cases of left anterior descending artery (LAD), accounting for 3.2%, 17 cases of left circumflex artery (LCX), accounting for 13.7% The related artery lesions were 75 cases (60.5%) in the proximal segment, 29 cases (23.4%) in the middle segment, 20 cases (16.1%) in the distal segment, 15 cases (50% -75%) of stenosis, accounting for 12.1% Stenosis ranged from 75% to 99% in 31 cases, accounting for 25.0%. There were 78 cases (100%) with occlusive disease in 78 cases, accounting for 62.9%. 4, The nature of the lesion: Thromboembolism in 103 cases accounted for 83.1%. Conclusions Infarct-related arteries in patients with acute inferior wall, posterior wall and right ventricular infarction: (1) predominantly right coronary artery disease followed by left circumflex coronary artery and rare cases of left anterior descending coronary artery disease; (2) inferior wall heart The infarct-related arteries in the infarct and inferior posterior wall myocardial infarction were the middle segment of the left anterior descending artery or the left circumflex branch. The distal lesion was slightly more and the infarct-related artery was in the proximal segment of the right coronary artery. The middle lesion was slightly more and the patients with right ventricular myocardial infarction For the right coronary proximal lesions; (3) more occlusive lesions; (4) more thrombotic lesions.