雌激素水平对绝经后女性急性心肌梗死发生的影响

目的:探讨分析绝经后女性雌激素水平的变化对发生心肌梗死的影响.方法:选取50例绝经后心肌梗死患者进行研究,了解分析患者内源性性激素水平,采用Logistics对患者性激素水平与急性心肌梗死之间的相关性.结果:检验结果显示,绝经后女性急性心肌梗死危险单因素分析,与雌酮、雌二醇、睾酮、腰臀比、体质比、高血压、糖尿病呈正相关,与雌二醇、腰臀比呈强正相关.结论:雌激素水平对绝经后女性急性心肌梗死的发生具有较为重要的影响作用.     

绝经后心肌梗死妇女的临床特点分析

目的 探讨绝经后妇女心肌梗死的临床特点及危险因素,为我们对绝经后冠心病特别是急性心肌梗死的预防与治疗做出一定的指导。资料与方法 选取到绝经后妇女83例的临床资料进行统计分析。结果 心梗组与非心梗组血脂的比较、年龄及绝经年限对患者的血脂的影响均没有统计学意义,绝经后发生心肌梗死患者的纤维蛋白原明显增加,胆固醇与心肌梗死有相关性。结论 绝经后女性的血脂,特别是胆固醇的早期干预和治疗,为减少绝经后女性冠心病特别是心肌梗死的发病率有一定的指导作用。     

绝经期前、后女性急性心肌梗死患者临床特点分析

目的探讨绝经期前、后女性急性心肌梗死(acute myocardial infarction,AMI)患者的危险因素、发病特点及预后,以提高诊疗效果。方法分析2003~2007年首都医科大学宣武医院收治的女性AMI患者共324例,依据是否绝经及绝经年限分组并对危险因素、临床表现、并发症和入院30d病死率进行比较。结果绝经前女性AMI患者与绝经后患者相比,高脂血症的发生率更低(P=0.005,OR值8.151);典型胸痛症状的发生与年龄(P=0.001,OR值0.881)及绝经年限(P=0.025,OR值2.600)差异有统计学意义;绝经年限与严重心律失常和心力衰竭(>KillipⅡ级)差异无统计学意义(P>0.05)。合并糖尿病和心力衰竭(>KillipⅡ级)是预测绝经后女性心肌梗死患者死亡率的独立危险因素(P=0.043,OR值1.081&P<0.001,OR值12.339)。结论绝经期前、后女性心肌梗死患者具有不同的临床特点,应结合其临床特点加强针对性的预防和诊疗措施。     

急性心肌梗死后心律失常发生时间规律的观察

急性心肌梗死(AMI)及其常见的心律失常并发症是造成患者死亡的主要原因,心律失常发生率与急性心肌梗死发生的时间、部位和范围有关[1]。为观察急性心肌梗死后心律失常的发生时间规律,我们对84例心肌梗死后并发心律失常患者进行敏感时段的预测及监护,现报道如下。资料与方法1.一般资料我科2004年1月至2006年12月共收治AMI患者84例,均进行24 h心电监护,均除外发生AMI前即患有心律失常者、入院即用抗心律失常药物者以及接受溶栓治疗者。其中男性67例,女性17例,年龄62~81岁。前壁心肌梗死12例、后壁心肌梗死5例、下壁心肌梗死15例、侧壁心肌…     

绝经前后女性急性心肌梗死患者冠心病危险因素对比研究

目的探讨绝经前后女性急性心肌梗死患者冠心病危险因素的特点。方法回顾性分析2005年1月～2010年1月解放军总医院收治的女性急性心肌梗死患者共246例,根据是否绝经及绝经年限进行分组,对各组的冠心病危险因素进行对比分析。结果绝经前组的平均体重指数、纤维蛋白原、总胆红素水平以及吸烟、低血红蛋白者比例与绝经后各组相比,差异均无统计学意义(P≥0.05)。绝经前组、绝经5年内组、绝经5～10年组的高血压和糖尿病者比例进行组间比较,差异无统计学意义(P≥0.05),绝经10年以上组高血压和糖尿病者比例均高于其他各组,差异有统计学意义(P<0.05)。绝经前组总胆固醇、三酰甘油、LDL-C平均水平与绝经后各组相比,差异无统计学意义(P≥0.05);绝经前组HDL-C平均水平高于绝经后各组,差异有统计学意义(P<0.05)。绝经前组高尿酸血症者比例低于绝经后各组,差异有统计学意义(P<0.05)。绝经前组有早发冠心病家族史者比例高于绝经后各组,差异有显著统计学意义(P<0.01)。应用Logistic回归进行多因素分析发现绝经年限与高尿酸血症有相关性(P=0.031,OR=0.767)。结论绝经前后女性急性心肌梗死患者的冠心病危险因素有所不同,应根据不同生理阶段女性冠心病的发病特点,做好女性冠心病的早期预防和诊治工作。     

绝经后女性子宫腔积液治疗分析

目的对绝经后子宫腔积液的治疗进行分析.方法选取2006年10月~2011年10月收治的25例绝经后女性子宫腔积液患者为研究对象,对绝经后女性患者发生宫腔积液的原因、高发因素、治疗方法及临床治疗效果进行统计和分析.结果引起绝经后患者发生子宫腔积液的主要原因是子宫内膜炎、子宫内膜增生、恶性肿瘤、宫腔内出血等原因,引起宫腔积液的高发因素是绝经后女性、高血压、阴道炎等.治疗方法依据子宫积液的发病原因分别采用手术、西药治疗、中医辨证治疗;经治疗后22例治愈,5例子宫内膜癌患者中有2例手术后予以孕激素治疗,情况良好,3例术后放、化疗,目前仍在治疗.结论引起绝经后女性子宫腔积液的主要原因是子宫内膜炎、子宫内膜增生、恶性肿瘤、宫腔内出血等,早期进行积极治疗,临床治疗效果较好.因此,对绝经后患者发生子宫腔积液应给予重视,尤其是绝经后老年患者应进行定期的健康检查.     

绝经前女性冠心病患者特点分析

目的：探讨绝经前女性冠心病患者的发病特点,为绝经前冠心病防治提供理论依据。方法：回顾性分析2011年1月至2015年7月行冠脉造影诊断为冠心病的绝经前女性患者168例发病特点,找到其发病规律。结果：绝经前女性急性心肌梗死独立相关的危险因素依次是高血压、体重指数、高甘油三酯、冠心病家族史、人格气质类型及吸烟。结论：高血压、体重指数、高甘油三酯、冠心病家族史、人格气质类型、吸烟是绝经前女性急性心肌梗死重要危险因素。     

绝经前女性冠心病患者特点分析

目的:探讨绝经前女性冠心病患者的发病特点,为绝经前冠心病防治提供理论依据。方法:回顾性分析2011年1月至2015年7月行冠脉造影诊断为冠心病的绝经前女性患者168例发病特点,找到其发病规律。结果:绝经前女性急性心肌梗死独立相关的危险因素依次是高血压、体重指数、高甘油三酯、冠心病家族史、人格气质类型及吸烟。结论:高血压、体重指数、高甘油三酯、冠心病家族史、人格气质类型、吸烟是绝经前女性急性心肌梗死重要危险因素。     

与应用口服避孕药相关的自发性冠状动脉夹层:病例报道与文献回顾

自发性冠状动脉夹层(SCAD)是急性冠状动脉综合征的一种罕见原因,其病理生理过程非常复杂。本文简要描述1例无传统心血管危险因素的50岁女性患者,因ST段抬高型急性心肌梗死而入院,入院后予溶栓治疗。值得注意的是,该患者在过去10年中口服避孕药。冠状动脉造影示左前降支远端夹层。     

未绝经女性急性心肌梗死8例临床分析

近年来，女性心血管疾病引起了医务界的广泛关注。根据2004年美国心脏病学会最新资料统计表明，在发达国家和地区心血管疾病已成为女性致死和致残的第一疾病，而且2／3女性猝死患者死于生前未曾发现心血管疾病，因此女性心血管疾病的预防已逐渐转变成为女性心血管危险因素的预防，且提高对女性心血管疾病的诊断意识成为临床心血管医生的工作重点。女性由于特殊的生理特性其患心血管疾病的临床特点有别于男性。一般而言，女性患冠心病的发病年龄较男性推迟10年左右，即一般发生在绝经后5～10年。但是临床上未绝经女性急性心肌梗死也时有发生，本文总结了8例女性绝经期前急性心肌梗死病例，通过复习有关文献，结合临床实践就其临床特点进行探讨。     

Treatment of spontaneous coronary artery dissection with drug-eluting stents

Spontaneous coronary artery dissection SCAD is a rare condition which may result in sudden coronary occlusion, acute myocardial infarction and sudden cardiac death. The prognosis of spontaneous coronary artery dissection is uncertain and optimal treatment is unknown. We describe a case of SCAD in a 29-year-old male with acute inferior wall myocardial infarction MI and post-MI angina that was treated with drug-eluting stents.     

Spontaneous coronary artery dissection causing myocardial infarction in an 18-year-old man: A case report

Spontaneous coronary artery dissection (SCAD), an uncommon cause of myocardial infarction, typically affects a younger, otherwise healthy population. There are currently no known direct causes of this condition, although some correlations have been noted. Commonly found in women, the asymptomatic presentation in men is very rare. Herein, we report the case of an 18-year-old man who presented to our institution with asymptomatic myocardial infarction secondary to a spontaneous dissection of the left anterior descending coronary artery. Until now, there is no specific guideline for SCAD. Choice of treatment should be tailored to the clinical condition of each individual patient.     

Spontaneous coronary artery dissection in a patient with systemic lupus erythematosis

Spontaneous coronary artery dissection (SCAD) is an uncommon condition that may lead to sudden coronary artery occlusion resulting in a fatal acute myocardial infarction. It usually affects young to middle age women. A Medline search from 1966 to 2001 (using keywords: coronary artery dissection and systemic lupus erythematosis) revealed no prior reports of coronary dissection in a patient with systemic lupus erythematosis (SLE). We describe a 48-year old woman with SLE who sustained a fatal spontaneous left main coronary artery dissection. Coronary angiogram was notable for marked variability in the size of coronary lumen from systole to diastole. This case demonstrates the need to consider SCAD in the evaluation of chest pain and myocardial infarction in patients with SLE. Furthermore, in the absence of classical angiographic findings of coronary dissection, a detailed review of phasic changes in coronary lumen during a cardiac cycle could help reach this diagnosis.     

Acute myocardial infarction in sickle cell anaemia associated with severe hypoxia

A 17 year old boy with sickle cell anaemia presented with acute myocardial infarction associated with severe hypoxia and reticulocytopenia. Ischaemic heart disease is rare in sickle cell anemia and in this case it is possible that the acute episode of hypoxia led to myocardial infarction.     

Clinical documentation of twenty cases of acute myocardial infarction in Papua New Guineans

As predicted, coronary artery disease is being recognized with increasing frequency in the town hospitals in Papua New Guinea. This report contains the clinical characteristics of 20 patients with acute myocardial infarction admitted to the Port Moresby General Hospital. The clinical features of acute myocardial infarction were typical of the disease anywhere. The seemingly rare frequency of angina of effort in this group of patients is an interesting observation. The high in-hospital case fatality rate observed here is alarming. Urban dwelling, the male gender, smoking and diabetes were important risk factors in the development of this disease in these patients.     

非ST段抬高心肌梗死相关因素探讨

目的：探讨非ST段抬高心肌梗死（NSTEMI）的相关因素。方法：对2002年1月～2003年12月所有住院确诊为急性心肌梗死的221例的临床资料进行回顾性分析，采用非条件Logistic回归分析评价各因素与非ST段抬高心肌梗死之间的关系。结果：（1）急性心肌梗死221例中非ST段抬高心肌梗死29例，占13．12％；ST段抬高心肌梗死192例，占86．88％。（2）Logistic回归分析显示：与非ST段抬高心肌梗死相关的因素为：年龄、性别、族别、高血压、糖尿病、吸烟与非ST段抬高心肌梗死无显著相关性。结论：年龄是非ST段抬高心肌梗死的保护因素，随着年龄增长，非ST段抬高心肌梗死比ST段抬高心肌梗死增加更明显。     

Unusual electrocardiographic manifestations in acute isolated right ventricular infarction

Electrocardiographic (ECG) manifestation of ST-segment elevation in the precordial leads during acute myocardial infarction is usually due to anterior myocardial infarction secondary to occlusion of the left coronary artery. Herein, we reported a rare case of isolated right ventricular infarction (RVI) in which the ECG mimicked that of acute anterior left ventricular infarction (LVI). A 64-year-old man had acute isolated RVI documented by positive cardiac enzymes and echocardiographic and angiographic findings. He developed hypotension. His ECG showed ST-segment elevation in the precordial leads V1 to V3 simulating that of acute anterior wall infarction. Coronary angiogram revealed total occlusion of the proximal right coronary artery with well-established collaterals from the left coronary artery to the posterior descending artery. This case report reminds us that the presence of diffuse ST-segment elevation in the precordial leads could be due to acute isolated RVI rather than acute anterior LVI. The differentiation of these two entities is important, as their therapies are quite different.     

Acute myocardial infarction in young adults: causes and management

The case report in this review illustrates an acute myocardial infarction in a young adult probably due to arterial thrombosis that can be attributed to a hypercoagulable state resulting from the nephrotic syndrome. Although rare, acute myocardial infarction should be considered in young adults presenting with chest pain. A detailed clinical history may help to identify the aetiology, and guide subsequent management, but diagnostic coronary angiography is essential. Careful risk factor modification and treatment of the underlying cause should reduce the incidence of recurrent cardiac events.     

Myocardial infarction following recombinant tissue plasminogen activator treatment for acute ischemic stroke: a dangerous complication

Thrombolysis with intravenous tissue plasminogen activator (t-PA) is currently an approved therapy for patients with acute ischemic stroke. Acute myocardial infarction (AMI) immediately following t-PA treatment for stroke is a rare but serious complication. A case of acute myocardial infarction (MI) following IV t-PA infusion for acute stroke was observed. This is a 52-year-old male with a known history of hypertension and chest pain, who subsequently developed MI four hours after IV t-PA was administered for acute ischemic stroke. The disruption of intra-cardiac thrombus and subsequent embolization to the coronary arteries may be an important mechanism. In addition, spontaneous recanalization of infarct-related arteries may be associated with greater myocardial salvage and better prognosis.

     

地震前后急性心肌梗塞患者的临床特征分析

目的分析地震前后急性心肌梗塞的临床特点。方法对地震后46例急性心肌梗塞进行分析,并与地震前31例急性心肌梗塞进行对比。结果地震后急性心肌梗塞住院患者增多,危险因素中,吸烟、饮酒、过度疲劳与地震前相比,有明显差异（P〈0.05）。结论地震后急性心肌梗塞住院病人增多,可能与地震后急性心肌梗塞某些危险因素如吸烟、饮酒、过度疲劳等增多有关。