Nakamura M, Ui K, Nakamura S, Tohma M, Yoshimura H, Kubo H, Degawa T, Ninomiya K, Yabuki S, Machii K
Third Department of Internal Medicine, Toho University School of Medicine, Ohashi Hospital, Tokyo.
J Cardiol. 1991;21(3):605-12.
The aim of this study was to investigate the incidence and development of coronary collateral circulations in patients with acute myocardial infarction (AMI). We categorized 165 patients with persistent 100% occlusion of the infarct-related artery into 6 groups according to the time from the onset of AMI to angiography. Group I consisted of 55 patients evaluated within 6 hours after the onset of AMI; Group II, 28 patients, between 6 and 12 hours after the onset; Group III, 12 patients, between 12 and 24 hours after the onset; Group IV, 11 patients, between 2 and 13 days after infarction; Group V, 46 patients, between 14 and 44 days after infarction; and Group VI, 13 patients, more than 45 days after infarction. Collateral vessels were applied a numerical score between 0 and 3 according to the degree of opacification of the native vessel distal to the occlusion. In 58%, 79%, 67%, 73%, 89%, and 92%, patients of Groups I to VI had evidence of collateral vessels, respectively. Well-developed collaterals were observed in 24% of Group I compared with 50%, 58%, 55%, 73% and 69% of patients in Groups II to VI, respectively. The mean coronary collateral scores were 0.9 +/- 0.1, 1.4 +/- 0.2, 1.4 +/- 0.3, 1.6 +/- 0.4, 2.0 +/- 0.2 and 2.2 +/- 0.3 for Groups I to VI, respectively. Patients with preinfarction angina had more well-developed collateral circulations than did patients without it, however, there was no significant correlation between the duration of previous angina and extent of coronary collaterals.
本研究旨在调查急性心肌梗死(AMI)患者冠状动脉侧支循环的发生率及发展情况。我们将165例梗死相关动脉持续完全闭塞的患者,根据从AMI发病至血管造影的时间分为6组。I组由55例在AMI发病后6小时内接受评估的患者组成;II组28例,发病后6至12小时;III组12例,发病后12至24小时;IV组11例,梗死2至13天;V组46例,梗死14至44天;VI组13例,梗死45天以上。根据闭塞远端自身血管的显影程度,侧支血管给予0至3的数字评分。I至VI组患者分别有58%、79%、67%、73%、89%和92%存在侧支血管证据。I组24%的患者观察到侧支循环良好,而II至VI组患者分别为50%、58%、'55%、73%和69%。I至VI组的平均冠状动脉侧支评分为0.9±0.1、1.4±0.2、1.4±0.3、1.6±0.4、2.0±0.2和2.2±0.3。梗死前有心绞痛的患者比无心绞痛的患者有更发达的侧支循环,然而,既往心绞痛的持续时间与冠状动脉侧支的程度之间无显著相关性。