急性心肌梗塞后心绞痛危险因素分析

５４例存活的急性心肌梗塞患者中，２３例（４２．６％）有梗塞后早期心绞痛（ＰＩＡ）．经多项危险因素的多元回归分析，发现年龄、性别、梗塞前心绞痛史、梗塞部位、心功能、高血压、糖尿病、高脂血症、肌酸磷酸激酶峰值和左室射血分数等与ＰＩＡ无关，唯有二维超声心动图的室壁运动分数指数（ＷＭＳＩ）与梗塞后心绞痛有关（Ｐ＝０．０００１）．说明室壁运动异常的范围大和严重与梗塞后心肌缺血有关。ＷＭＳＩ≥２者应作冠状动脉造影。

ANALYSIS OF RISK FACTORS IN POSTINFARCTION ANGINA

he clinical and echocardiographic variables related to postinfarction angina were evaluated in 54 patients with acute myocardial infarction. All patients underwent 2D echocardiography at 2-3 weeks after infarction. Wall motion analysis was quantified with a wall motion score index(WMSI) based on16 left ventricular wall segments.Among the 54 patients with acute myocardial infarction 23 (42.6%)had early postinfarction angina. Multiple regression analysis demonstrated no significant difference between the patients with and without postinfarction angina in age,sex,location of infarction, Killip classification,previous angina, hypertension,hyperlipidemia,diabetes mellitus, creatine kinase level and left ventricular ejection fraction,In comparison with patients without postinfarction angina, patients with postinfarction angina had higher WMSI.It indicates that postinfarction angina appears to be related more to mvocardial ischemia rather than to the infarct of myocardium.