急性心肌梗死患者自发再通与其危险因素状况和预后的关系分析
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[摘要] 目的 观察急性心肌梗死患者自发再通与其危险因素状况和预后的关系。方法 连续入选2008～2010年于我院就诊的未予静脉溶栓、直接行急诊冠脉造影及急诊PCI的STEMI患者共219例，分为自发再通(SR)组57例和非自发再通(NSR)组162例，对比分析两组危险因素和心肌酶学峰值及达峰时间。结果 两组患者除HDL-C水平无显著性差异外，SR组的CHO、LDL-C、TG水平均明显高于NSR组(P<0.05)；SR组的心肌酶(CK、CK-MB)峰值明显低于NSR组(P<0.05)；达峰时间对比，SR组也低于NSR组，但差异无统计学意义(P>0.05)。结论 SR组患者血脂水平高于NSR组，SR对减少心肌坏死程度有重要意义，从而影响并改善AMI的预后。
[关键词] 急性心肌梗死；自发再通；血脂；经皮冠状动脉介入治疗
[中图分类号] R542.2+2 [文献标识码] B[文章编号] 1673-9701(2011)19-37-02
The Relationship between Spontaneous Reperfusion with Risk Factors and Prognosis in Patients with Acute Myocardial Infarction
LIU ZhiqiangSU ShuhongWU XiaoZHANG JingyuLIU Lingling
Department of Cardiology, Central Hospital of Xinxiang, Xinxiang 453000, China
[Abstract] Objective To analyse the relationship among spontaneous reperfusion, risk factors and prognosis in patients with acute myocardial infarction. Methods From 2008 to 2010, 219 consecutive STEMI patients without previous intravenous thrombolytic therapy received emergency coronary angiography and PCI. These patients were divided into SR group (antegrade flow 2-3 grades) and NSR group (antegrade flow 0-1 grade) according to TIMI. Risk factors，peak values of CK and CK-MB and the time to peak of cardiac enzyme were compared. Results The levels of CHO, LDL-C, TG in SR group were higher than NSR group (P<0.05); The time to peak of cardiac enzyme in SR group was shorter than NSR group, but the difference was not significant (P>0.05). Conclusion The level of blood lipid in SR group is higher than that of NSR group; SR reduces the degree of infarction and improves the prognosis.
[Key words] Acute myocardial infarction; Spontaneous reperfusion; Blood lipid; Percutaneous
coronary intervention
高血压病、糖尿病、血脂代谢异常、吸烟等是冠心病的常见危险因素，它促进动脉粥样硬化病变的形成和冠心病的发病，而急性心肌梗死(acute myocardial infarction，AMI)是冠心病的严重阶段。本文分析了急性心肌梗死患者自发再通与其危险因素状况和预后的关系，现报道如下。
1 资料与方法
1.1 一般资料
连续入选2008～2010年于我院就诊的未予静脉溶栓、直接行急诊冠脉造影及急诊冠状动脉介入治疗(percutaneous coronary intervention，PCI)的ST段抬高性急性心肌梗死(ST-elevation myocardial infarction ......
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