急性心肌梗死后梗死相关动脉自发性开放的临床意义

目的 :探讨急性心肌梗死 (AMI)后梗死相关动脉 (IRA)自发性开放的临床意义。方法 :对AMI后 10 9例非溶栓病人 10～ 14天行冠造 ,观察 47例TIMIⅡ～Ⅲ级 (自发开放组 )者恶性室性心律失常、心功能状况、IRA狭窄程度及 1个月时心脏超声结果 ,并与 62例TIMI 0～Ⅰ级 (未开放组 )者进行对比。结果 :自发开放组心功能较未开放组明显改善 (P <0 .0 1)、左室扩大及IRA狭窄≥ 70 %者例数较少 (P <0 .0 1) ,多支病变的发生在两组间无明显差异。结论 :IRA的晚期自发性开放 ,对失去溶栓机会或有溶栓禁忌证的患者有减少严重心律失常的发生、阻止心腔扩大和改善心功能的作用

The Clinical Value of Spontaneous Reperfusion in Patients with Acute Myocardial Infarction

Objective:To investigate the clinical characteristics and values of spontaneous reperfusion in patients with acute myocardial infarction. Methods:Coronary angiography was performed during 7～14 days from the onset of AMI in patients who did not receive thrombolytic therapy. Compared the occurrence of serious ventricular arrhythmias?left ventricular function ?the stenosis degree of IRA(infarctrelated artery)? the echocardiographic findings between forty-seven patients with TIMI grade 2～3(spontaneous reperfusion group) and sixty-two patients with TIMI grand 0～1(no-reperfusion group).Results:Compared with no-reperfusion group, the spontaneous reperfusion group had an increased left ventricular function [LVEF(72±30.1)% vs(51±26.2)% P<0.01] ?The number of cases with left ventricular enlargement and significant stenosis degree(≥70% of IRA ) was less (P<0.01).The incidence of multiple vessel disease had not significant difference between two groups. Conclusions:Later spontaneous reperfusion of IRA have a better effect on reducing the happen in serious ventricular arrhythmias ?improving ventricular function and preventing the left ventricular enlargement in the patient who had lost the chance of thrombolytic therapy or contraindication of thrombolytic therapy.