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[非溶栓治疗的下壁心肌梗死预后良好吗?]

[Is the prognosis of non-thrombolysed inferior infarction benign?].

作者信息

Tabone X, Georges J L, Freitas da Frota M A, Le Feuvre C, Berdah J, Heulin A, Metzger J P, Vacheron A

机构信息

Clinique cardiologique, hôpital Necker, Paris.

出版信息

Arch Mal Coeur Vaiss. 1990 Apr;83(4):517-21.

PMID:2111672
Abstract

Between 1978 and 1983, 2,970 coronary angiographies were performed at the Cardiology Clinic of Necker Hospital; 220 survivors of an initial Q-wave inferior infarction who had not received thrombolytic therapy were selected. The ejection fraction was 55 +/- 11 per cent, and the indexed end diastolic left ventricular volume was 108 +/- 29 ml/m2. The left anterior descending artery was diseased in 57 per cent of cases. The incidence of multivessel disease was 67 per cent. Two hundred and eleven patients (96%) were followed up for 79 +/- 22 months. The prevalence of cardiovascular events was: cardiac deaths: 22 (10%), recurrent infarction: 20 (9%), angina requiring coronary bypass surgery: 60 (28%), cardiac failure: 22 (10%). The 10 year actuarial survival was significantly lower in patients with an ejection fraction less than 45 per cent (46% vs 91%) and in patients with triple vessel disease (62% vs 92% and 88%). The survival was not lower in patients with stenosis of the left anterior descending artery.

摘要

1978年至1983年间,内克尔医院心脏病科进行了2970例冠状动脉造影;选取了220例初次下壁Q波心肌梗死幸存者,这些患者未接受过溶栓治疗。射血分数为55±11%,左心室舒张末期容积指数为108±29 ml/m²。57%的病例左前降支动脉病变。多支血管病变的发生率为67%。211例患者(96%)接受了79±22个月的随访。心血管事件的发生率为:心源性死亡:22例(10%),再发梗死:20例(9%),需要冠状动脉搭桥手术的心绞痛:60例(28%),心力衰竭:22例(10%)。射血分数低于45%的患者(46%对91%)和三支血管病变的患者(62%对92%和88%)10年精算生存率显著较低。左前降支动脉狭窄的患者生存率并未降低。

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