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报告经尸检证实的急性心肌梗塞(AMI)继发脑梗塞(CI)5例。CI灶位于大脑中动脉区4例(左3、右1),前动脉区1例;新鲜与陈旧心梗并存4例,心脏动脉瘤、左室内附壁血栓(MT)、二尖辨狭窄各2例;心主动脉、脑基底动脉及大脑中动脉粥样硬化Ⅲ～Ⅳ度5例。与同期AMI尸检无CI13例心脑病理临床资料作比较,认为CI发生除心源性脑栓塞外,低血压、脑动脉粥样硬化也是重要因素,提出AMI早期应用抗凝治疗、及时纠正心衰和低血压,避免MT的形成与脱落是防治CI发生的重要措施。
Report autopsy confirmed acute myocardial infarction (AMI) secondary to cerebral infarction (CI) in 5 cases. CI was located in 4 cases of middle cerebral artery (left 3, right 1), anterior artery in 1 case; 4 cases of fresh and old myocardial infarction, cardiac aneurysm, left ventricular wall thrombosis (MT), mitral stenosis 2 cases; heart aorta, basilar artery and middle cerebral artery atherosclerosis Ⅲ ~ Ⅳ in 5 cases. In comparison with the clinical data of CI 13 autopsy in the same period, there was no significant difference in the clinical data of CI 13 cases of cardiac and cerebral pathology. In addition to the cardiogenic cerebral embolism, hypotension and cerebral atherosclerosis were also important factors. It was suggested that AMI should be given anticoagulant therapy in the early stage to correct heart failure And hypotension, to avoid the formation of MT and shedding is an important measure to prevent CI occurrence.