青年急性心肌梗死患者冠状动脉造影正常的临床分析

目的:探讨青年急性心肌梗死(AM I)患者冠状动脉(冠脉)造影正常的发生率,并分析其临床特点。方法:回顾分析我院1995年5月~2004年10月收治的436例AM I患者冠脉造影结果及有关冠心病的危险因素。结果:本组436例中,冠脉造影异常402例(异常组),正常34例,其中青年AM I患者冠脉造影正常8例(正常组),提示青年冠脉造影正常者多无心绞痛、高血压病、糖尿病病史及血酯异常,但大量吸烟者居多。结论:在冠脉造影正常的青年AM I中,冠脉痉挛在心肌梗死的发病中可能起着十分重要的作用,急性血栓形成伴血栓自溶亦是其病理改变之一。

Clinical Analysis of Normal Coronary Arteriographic Findings in the youth with Acute Myocardial Infarction

Objective:To investigate the rate of normal coronary arteriographic findings in the youth with acute myocardial infarction(AMI) and their clinical features.Methods:A retrospective analysis was conducted on the findings on coronary arteriography(CAG) and the risk factors for coronary heart disease in 436 patients with AMI hospitalized from May in 1995 to October,2004.Results:Of the 450 ANI patients,402 were found to have abnormal CAG findings and 43 showed normal ACG findings;of these 34 cases,8 were young.Their clinical history showed these younger patients with AMI and normal CAG had been free of angina pectoris,hypertension,diabetes millitus and hyperlipidemia,but most of them had been heavy smokers.Conclusions:Negative CAG finding was not infrequent in patients with AMI.The results of the present paper indicated that coronary artery spasm might play an important role in pathogenesis of AMI with normal CAG.And acute thrombosis and auto thromobolysis were also one of the pathologic changes.