左回旋支动脉阻塞相关的心肌梗死的临床特征

目的：探讨左回旋支动脉阻塞相关的ST段抬高型与非ST段抬高型急性心肌梗死患者的临床特征。方法：对连续收治的86例冠状动脉左回旋支相关的急性心肌梗死行冠状动脉介入治疗患者的临床资料进行回顾性分析，根据心电图的表现分为两组，ST段抬高型心肌梗死（STEMI）组（32例），非sT段抬高型心肌梗死（NSTEMI）组（54例），比较两组临床特征及预后。结果：与NSTEMI组比较，STEMI组血清肌酐水平（80±23）／μmmol／L比（100±30）μmmol／L]，主动脉内球囊反搏（3．7％比18．8％，P〈0．05）、有创呼吸机使用（1．9％比15．6％）、缺血性二尖瓣返流（13．0％比40．6％）、完全性房室传导阻滞（0比9．4％），左冠状动脉优势型比例（7．4％比28．1％，P〈0．05）显著升高，左室舒张末期直径（LVEDd）（46±4）mm比（48±5）mm]显著扩大（P〈0．05或〈0．01）。STEMI组三支血管病变显著低于NSTEMI组（46．9％比72．2％，P〈0．05），两组住院死亡率无显著差异（3．1％比0％，P〉0．05）。结论：左回旋支动脉阻塞相关的ST段抬高型心肌梗死比非ST段抬高型心肌梗死的心功能差，这可能与左冠状动脉优势型较多有关。

Clinical characteristics of myocardial infarction related with left circumflex artery occlusion

Objective： To explore the clinical characteristics of ST elevation and non-ST elevation acute myocardial in-farction （AMI） related with left circumflex artery （LCX） occlusion. Methods： Clinical data of 86 consecutively en- rolled patients with LCX occlusion-related AMI undergoing percutaneous coronary intervention （PCI） were retro-spectively analyzed. According to manifestations of electrocardiography, the patients were divided into ST elevation myocardial infarction （STEMI） group （n=32） and non STEMI （NSTEMI） group （n= 54）. Clinical features and prognosis were compared between two groups. Results. Compared with NSTEMI group, there were significant in crease in serum level of creatinine （80±23） μmmol/L vs, （100±30） μmmol/L], in rates of intra-aortic balloon counterpulsation （IABP） support （3.7% vs. 18.8%）, usage of invasive respiratory machine （1.9% vs. 15.6%）, ischemic mitral reflux （13.0% vs. 40.6%）, complete atrioventricular block （0 vs. 9.4%）, proportion of left coro-nary artery dominant type （7.4 % vs. 28.1% ） and left ventricular end-diastolic diameter LVEDd, （46±4） mm vs. （48±5） mm]; And significant decrease in percentage of triple-vessel coronary disease （72.2% vs. 46.9%） in STEMI group, P〈0.05 or〈0.01. There was no significant difference in mortality rate during admission （3.1% vs. 0, P〉0.05） between STEMI group and NSTEMI group. Conclusion： Compared with patients with NSTEMI, pa-tients with STEMI have poorer heart function in patients with left circumflex artery occlusion, which may be related to more left coronary dominance.