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目的:研究冠状动脉侧支循环形成与心肌缺血、心肌梗死发生的时间关系。方法:回顾分析412例经冠状动脉造影证实的冠状动脉完全或次全闭塞患者,先将有心肌梗死病史的患者分为3组:A组(心肌梗死后1个月内)、B组(1个月～1年)、C组(1年以上)。仅有心肌缺血者同样根据缺血时间(上述3个时间段)分为A、B、C组。分别观察侧支循环形成良好率,进行对比分析。再根据闭塞血管将所有患者分为前降支、回旋支、右冠状动脉3组观察其侧支循环形成情况。结果:有心肌梗死及心肌缺血病史者A、B、C组患者侧支循环形成的良好率两两比较均差异无统计学意义(P>0.05)。右冠状动脉完全或次全闭塞时侧支循环形成良好率明显高于左冠状动脉;前降支与右冠状动脉比较、回旋支与右冠状动脉比较均差异有统计学意义(P<0.05)。结论:心肌梗死和心肌缺血随着时间的延长侧支循环良好情况无显著改变。
Objective: To study the relationship between the formation of coronary collateral circulation and the occurrence of myocardial ischemia and myocardial infarction. Methods: A total of 412 patients with complete or subtotal coronary artery occlusion confirmed by coronary angiography were retrospectively analyzed. Patients with a history of myocardial infarction were divided into three groups: group A (within 1 month after myocardial infarction), group B Month to 1 year), group C (more than 1 year). Only myocardial ischemia were also divided into ischemic time (the above three time periods) were divided into A, B, C group. To observe the formation of collateral circulation good rate, comparative analysis. According to occlusion of blood vessels, all patients were divided into three groups: anterior descending branch, circumflex branch and right coronary artery. The formation of collateral circulation was observed. Results: There was no significant difference in the rate of collateral circulation between groups A, B and C with myocardial infarction or myocardial ischemia (P> 0.05). The rate of formation of collateral circulation in complete or subtotal right coronary artery occlusion was significantly higher than that in the left coronary artery. The anterior descending branch and right coronary artery had statistically significant differences in both collaterals and right coronary artery (P <0.05). Conclusion: The myocardial infarction and myocardial ischemia with prolonged collateral circulation did not change significantly.