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目的分析ST段抬高型急性心肌梗死(ST-elevation myocardial infarction,STEMI)与非STEMI(non-STEMI,NSTEMI)患者发生心脏破裂的临床特征。方法急性心肌梗死后心脏破裂患者59例,根据心电图表现分为STEMI组48例和NSTEMI组11例,对存活患者进行跟踪随访,并将2组患者临床资料进行统计分析。结果 2组基线资料比较差异无统计学意义(P>0.05);STEMI组血白细胞计数[(11.91±5.01)×109/L]、谷丙转氨酶[(49.21±25.13)u/L]以及脑钠肽峰值[396.65(110.00,552.03)ng/L]高于NSTEMI组[(8.01±2.85)×109/L、(21.18±7.31)u/L、43.00(10.00,245.30)ng/L],凝血酶原时间[(12.56±1.93)s]较NSTEMI组[(11.20±0.59)s]明显延长,左室射血分数[(47.93±8.38)%]低于NSTEMI组[(59.36±12.92)%],2组比较差异均有统计学意义(P<0.05);2组住院期间药物使用情况比较差异无统计学意义(P>0.05),2组院内病死率均较高(85.4%vs 81.8%),但院内急性心力衰竭、再发心肌梗死、出血、心因性死亡发生率以及心脏破裂距心肌梗死时间比较差异无统计学意义(P>0.05);NSTEMI组院内脑梗死发生率(9.09%)高于STEMI组(0)(P<0.05)。结论心肌梗死后心脏破裂患者病死率高,STEMI患者心脏破裂风险高于NSTEMI患者,可能与心肌细胞大量坏死相关。
Objective To analyze the clinical characteristics of cardiac rupture in patients with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Methods Fifty-nine patients with heart rupture after acute myocardial infarction were divided into STEMI group (48 cases) and NSTEMI group (11 cases) according to the electrocardiogram (ECG) status. The surviving patients were followed up and the clinical data of the two groups were statistically analyzed. Results There was no significant difference in baseline data between the two groups (P> 0.05). The number of leukocyte in STEMI group was (11.91 ± 5.01) × 109 / L and [49.21 ± 25.13] u / L] The peak value of peptide [396.65 (110.00, 552.03) ng / L] was higher than that in NSTEMI group [(8.01 ± 2.85) × 109 / L, (21.18 ± 7.31) u / L, 43.00 Compared with NSTEMI group [(11.20 ± 0.59) s], the time of left ventricular ejection fraction [(47.93 ± 8.38)%] was significantly lower than that of NSTEMI group (59.36 ± 12.92)%, (P <0.05). There was no significant difference in medication use between the two groups during hospitalization (P> 0.05). The hospital mortality rates in the two groups were higher (85.4% vs 81.8%), However, there was no significant difference in the incidence of acute heart failure, recurrent myocardial infarction, hemorrhage, cardiac death and myocardial infarction between the two groups (P> 0.05). The incidence of cerebral infarction in the NSTEMI group (9.09%) was high In the STEMI group (0) (P <0.05). Conclusion The mortality of patients with heart rupture after myocardial infarction is high. The risk of heart rupture in patients with STEMI is higher than that in patients with NSTEMI, which may be related to the massive necrosis of myocardial cells.