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目的分析急性下后壁伴右心室心肌梗死患者,右冠状动脉作为梗死相关动脉罪犯病变造影特点。方法60例明确诊断急性下壁、正后壁或右心室心肌梗死的患者为本院2002年1月～2003年12月收入院,并接受冠状动脉造影及介入治疗的病例。最小年龄31岁,最大年龄80岁,平均年龄57±11岁。所有资料采用SAS软件处理,以P<0.05作为有显著性差异。结果(1)临床特点:本组入选60例患者,男性占83.3%,女性占16.7%,男女比例5∶1,男性明显高于女性(P<0.0001)。男女患者发病年龄无显著性差异(P=0.05878)。40岁以上者占绝大多数;(2)心电图特征:60例经心电图确诊的急性下壁、正后壁心肌梗死患者中,55例合并右心室梗死,占91.7%;(3)冠脉造影特征:60例患者中1例为冠状动脉左优势型,4例拒绝行冠状动脉造影。,其余55例患者梗死相关动脉均为右冠状动脉,罪犯病变在近段者18例(32.7%),其中15例完全闭塞,中段24例(43.6%),13例完全闭塞,远段5例(9.1%),1例完全闭塞;后侧支3例(5.5%),2例完全闭塞,后降支4例(7.3%),2例完全闭塞;锐缘支1例(1.8%),以右冠状动脉近、中段狭窄或闭塞最常见(占76.4%)。在罪犯病变狭窄程度方面:轻、中度狭窄者5例(5.5%);重度狭窄19例(34.5%);完全闭塞33例(60%);(4)左心室功能:全组平均EF正常(60%±13%)。结论在急性下、后壁伴右心室心肌梗死患者,右冠状动脉作为梗死相关动脉最为常见。罪犯病变以近、中段重度狭窄或闭塞为主。
Objective To analyze the characteristics of angiography of the right coronary artery as the lesion-related artery criminals in patients with acute inferior posterior wall and right ventricular myocardial infarction. Methods Sixty patients with definite diagnosis of acute inferior wall, posterior wall or right ventricular myocardial infarction were admitted to our hospital from January 2002 to December 2003 and underwent coronary angiography and interventional therapy. The youngest age of 31 years old, the oldest age of 80 years, mean age 57 ± 11 years old. All data were processed using SAS software with P <0.05 as a significant difference. Results (1) Clinical features: 60 patients were enrolled in this study. There were 83.3% males and 16.7% females. The ratio of males to females was 5: 1, significantly higher in males than in females (P <0.0001). There was no significant difference in age at onset between men and women (P = 0.05878). (2) Electrocardiogram characteristics: 55 cases of acute inferior wall and posterior wall myocardial infarction diagnosed by electrocardiogram in 55 patients with right ventricular infarction accounted for 91.7%; (3) Coronary angiography Characteristics: One of the 60 patients had a left dominant coronary artery and 4 patients refused coronary angiography. , While the other 55 patients were all right coronary arteries. Among them, 18 cases (32.7%) had the proximal lesion, of which 15 were completely occluded, 24 were middle (43.6%), 13 were completely occluded and 5 were distal (9.1%), complete occlusion in 1 case, complete occlusion in 3 cases (5.5%), complete occlusion in 2 cases, complete remodeling in 4 cases (7.3% Right coronary artery near the middle of the narrow or occlusion of the most common (76.4%). There were 5 cases (5.5%) with mild or moderate stenosis, 19 cases (34.5%) with severe stenosis, 33 cases (60%) with complete occlusion, and 4 cases with left ventricular function (60% ± 13%). Conclusion In the acute and posterior wall with right ventricular myocardial infarction patients, the right coronary artery as the most common infarct-related artery. Prone to lesion in the near, middle severe stenosis or occlusion-based.