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目的探讨侧支循环形成对急性心肌梗死患者近期预后的影响。方法选取行冠状动脉造影的急性心肌梗死患者130例,根据造影结果按照Rentrop分级方法将其分为侧支良好组(n=43)和侧支不良组(n=87)。对比分析两组的临床资料、左心室功能、肌酸激酶及肌酸激酶同工酶峰值浓度和临床预后等。结果两组年龄、性别及既往史等临床资料差异无统计学意义(P>0.05),非Q波心肌梗死和梗死前心绞痛在侧支良好组较为多见,并且多支病变的发生率较侧支不良组升高;而侧支良好组左心室射血分数优于侧支不良组(P<0.01),左室舒张末期压则低于侧支不良组(P<0.01);Cortina室壁运动评分侧支良好组低于侧支不良组,差异有统计学意义(P<0.01);侧支良好组肌酸激酶和肌酸激酶同工酶峰值浓度低于侧支不良组(P<0.01);院内并发症及临床心脏事件的发生率侧支良好组优于侧支不良组。结论急性心肌梗死前心绞痛提示侧支循环丰富,急性心肌梗死后心绞痛提示主要不良心血管事件(Mace)高。急性心肌梗死前侧支循环的形成对急性缺血心肌具有保护作用,在一定程度上减小急性心肌梗死范围,减少和预防恶性心血管事件的发生。
Objective To investigate the effect of collateral circulation on the short-term prognosis of patients with acute myocardial infarction. Methods A total of 130 patients with acute myocardial infarction underwent coronary angiography were enrolled. According to the results of Rentrop classification, they were divided into two groups according to Rentrop classification: n = 43 and n = 87. The clinical data, left ventricular function, creatine kinase and creatine kinase isoenzyme peak concentration and clinical prognosis were compared between the two groups. Results There was no significant difference in age, gender and past history between the two groups (P> 0.05). Non-Q-wave myocardial infarction and pre-infarction angina were more common in the collateral well and the incidence of multi-vessel lesion was (P <0.01), left ventricular end diastolic pressure was lower than that of collateral dysfunction group (P <0.01); Cortina wall motion The score of collateral good group was lower than that of collateral bad group, the difference was statistically significant (P <0.01). The peak concentration of creatine kinase and creatine kinase isozyme in collateral good group was lower than that in collateral collaterals group (P <0.01) ; The incidence of nosocomial complications and clinical cardiac events was better in collateral support than in collateral support. Conclusions Pre-AMI angina pectoris has abundant collateral circulation and angina pectoris after acute myocardial infarction suggests that the main adverse cardiovascular event (Mace) is high. The formation of collateral circulation before acute myocardial infarction has a protective effect on acute ischemic myocardium, to a certain extent reduce the scope of acute myocardial infarction, reduce and prevent the occurrence of malignant cardiovascular events.