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急性心肌梗塞延伸(extension)见于血浆肌酸磷酸激酶MB(BM-CK)恢复正常值之前,更多见于病程的第5～7天血浆MB—CK恢复正常后再次升高,临床发生率为8～9%,与无延伸者相比住院死亡率增加1倍,心源性休克增加3倍,但出院后死亡率无差异。住院第2天后出现复发性心绞痛、过去有心肌梗塞病史和心电图有ST段压低者有可能发生心肌梗塞延伸。由于多于一半的病人无症状,经常漏诊,预防漏诊,预防措施为经常进行酶学检查。心肌梗塞延伸多见于无Q波型心肌梗塞,危险性高,应考虑早期冠状动脉造影及尽可能采用介入治疗,减少早期住院死亡率。
Acute myocardial infarction (extension) seen in plasma creatine kinase MB (BM-CK) before returning to normal, more common in the course of the first 5 to 7 days plasma MB-CK returned to normal again after the rise, the clinical incidence rate of 8 ~ 9%. Compared with no extension, in-hospital mortality increased 1-fold and cardiogenic shock increased 3-fold. However, there was no difference in mortality after discharge. Recurrent angina pectoris occurs after 2 days of hospitalization. Myocardial infarction extension may occur in the past when there was a history of myocardial infarction and ECG with ST depression. As more than half of patients asymptomatic, often missed diagnosis, prevention of missed diagnosis, preventive measures for regular enzymatic examination. Myocardial infarction more common in Q-wave myocardial infarction extension, high risk, should consider early coronary angiography and interventional treatment as far as possible to reduce the early in-hospital mortality.