摘要
目的探讨老年心肌梗死伴与不伴心脏破裂的临床病理差异。方法将107例尸检证实的老年人心肌梗死分为心脏破裂与未破裂两组(破裂组22例,未破组85例),并进行临床病理对照。结果破裂组年龄(79·1±9·1岁)高于未破组(71·8±10·9岁,P<0·01),女性(11例,50·0%)多于未破组(21例,24·6%,P<0·05),有心绞痛史者(10例,45·5%)明显少于未破组(74例,87·1%,P<0·01),初发性心肌梗死(17例,77·3%)多于未破组(44例,52·3%,P<0·05),冠状动脉主要分支明显狭窄(36支,40·9%,平均1·64支/人)明显少于未破组(194支,57·1%,平均2·28支/人,P<0·01),单支病变(13例,59·1%)多于未破组(29例,33·8%,P<0·05)。心脏破裂部位以前壁近心尖处多见。结论高龄、女性、初发、既往无心绞痛史、冠脉单支病变者心脏破裂常见,破裂部位多见于前壁近心尖处。
Objective To investigate different clinicopathologic changes in myocardial infarction with and without cardiac rupture in the gerontal patients. Methods 107 gerontal patients with myocardial infarction （rupture group 22, non-rupture group 85） confirmed by necropsy during Jan 1980 to Oct. 2003 were analyzed to compare the clinicopathologic findings between patients with cardiac rupture and without rupture. Results The mean age of rupture group was higher than that of non-rupture （79. 1±9. 1 vs 71.8± 10. 9 years old, P= 0. 0059）. The number of female patients （50, 0% vs 24. 6%, P：0. 0209） and the the number of patients suffering from myocardial infarction for the first time （57. 3% vs 52. 3%, P=0.0312） were both greater in the rupture group. Previous angina pectoris was significantly less frequently found in the rupture group compared with non-rupture group （45. 5% vs 87. 1%, P=0.0000）. The mean number of major coronary arteries with over 75% stenosis was significantly lower in the rupture group （1.64 vs 2. 28 brancbes/person, P= 0. 0068）. The percentage of single major coronary arteries with significant stenosis was more often seen in the rupture group （59. 1% vs 33. 8%, P= 0. 0325）. The site of cardiac rupture was more frequently located in anterior wall near the apex. Conclusion The results suggested that cardiac rupture occurred more often in older and female patients, in first myocardial infarction episode, with infrequent previous angina pectoris, and frequently involving a severe single coronary artery disease compared with those patients without cardiac rupture. The common location of rupture was anterior wall near the apex.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2006年第10期1007-1008,共2页
Medical Journal of Chinese People's Liberation Army
关键词
心肌梗塞
心脏破裂
梗塞后
老年人
冠状动脉疾病
myocardial infarction
heart rupture, post-infarction
aged
coronary disease
作者简介
段留法，医学博士，副主任医师。主要从事冠心病、高血压的基础与临床研究。已发表论文16篇
