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目的 探讨冠状动脉 (冠脉 )造影正常的急性心肌梗死 (AMI)的主要危险因素和预后。方法 从 1996年7月至 2 0 0 3年 8月对AMI行冠脉造影 5 30例中发现造影正常AMI 2 2例 ,按年龄将其分成中年人和老年人两组 ,并比较两者主要危险因素和预后。结果 冠脉造影正常的AMI 2 2例。中年人组 :13例 ,高血压 7/ 13,长期大量吸烟 8/ 13;老年人组 :9例 ,高血压 9/ 9,长期大量吸烟 3/ 9,两组有明显统计学差异。而高胆固醇血症、糖尿病、大量饮酒史比较 ,无明显统计学差异。比较住院期间严重心律失常、心力衰竭 ,均无明显统计学差异。 6个月心脏事件随访包括 :再次AMI、心力衰竭、复合终点事件 ,均有明显统计学差异 ;而心绞痛、心源性死亡比较 ,无明显统计学差异。结论 高血压可能为老年人冠脉造影正常AMI的主要危险因素 ;长期大量吸烟为中年人的主要诱因 ,中年人预后良好 ,老年人预后则相对较差
Objective To investigate the main risk factors and prognosis of acute myocardial infarction (AMI) with normal coronary arteries (coronary angiography). Methods From July 1996 to August 2003, 52 patients with angiographically normal AMI were found in 5 30 patients undergoing AMI coronary angiography. They were divided into middle-aged and elderly patients by age and compared with each other The main risk factors and prognosis. Results Coronary angiography was normal in 2 2 cases. Middle-aged group: 13 cases, high blood pressure 7/13, long-term mass smoking 8/13; old group: 9 cases, hypertension 9/9, long-term mass smoking 3/9, the two groups were significantly different. The hypercholesterolemia, diabetes, a large number of drinking history, no significant statistical difference. Comparison of serious arrhythmia during hospitalization, heart failure, no significant statistical difference. Six-month follow-up of cardiac events included: AMI again, heart failure, and composite end points. There was a statistically significant difference. However, no significant difference was found in angina pectoris and cardiac death. Conclusions Hypertension may be the main risk factor of normal AMI in coronary angiography in the elderly. Long-term heavy smoking is the main cause of middle-aged people, the prognosis of middle-aged people is good, and the prognosis of elderly is relatively poor