冠状动脉造影大致正常的急性心肌梗死患者临床分析

目的 探讨急性心肌梗死(AMI)患者冠状动脉造影大致正常的检出率、伴随的临床症状因素和发生的机制。方法 回顾性分析311例接受冠状动脉造影检查的AMI患者，探讨冠状动脉造影大致正常的AMI患者的临床特点。结果 311例AMI患者中检出冠状动脉大致正常者16例(5．15％)，平均年龄47．6岁，其中45岁以下占56．3％(9／16)，有吸烟史者66．6％(10／16)，诱因为情绪激动者25％(4／16)，发病前有过度劳累史者50％(8／16)，既往有心绞痛病史者仅为12．5％(2／16)。5例患者曾行静脉溶栓治疗且均获成功(5／5)。结论 正常或轻度异常冠脉患者亦可发生AMI，吸烟和过度劳累可能为诱发冠脉痉挛而导致AMI的重要因素。大致正常冠脉AMI患者的实验室检查和心电图的演变与冠脉异常的ANI患者无明显差别。

Clinical analysis of acute coronary infarction patients with roughly normal coronary arteriographic findings]

OBJECTIVE: To investigate the detection rate and possible causes of acute coronary infarction (AMI) patients with roughly normal coronary arteriographic (CAG) findings. METHOD: A retrospective analysis was conducted in 311 cases of AMI undergoing CAG examination. RESULT: Of these 311 patients, 16 patients, whose age averaged 47.6 years, had roughly normal findings in CAG, including 9 below the age of 45 years, 10 with smoking history, and 5 with successful thrombolysis. CONCLUSION: Patients with normal or roughly normal CAG finding might also have AMI likely induced by coronary artery thrombosis and spasm.