Park S E, Tani A, Minamino T, Azuma J, Kishimoto S
Division of Cardiology, Sakurabashi-Watanabe Hospital.
Cardiology. 1990;77(2):121-9. doi: 10.1159/000174592.
The clinical features of acute non-Q wave myocardial infarction (NQMI) with R wave regression and no ST segment depression are distinct from those of acute Q wave myocardial infarction (QMI). NQMI patients showed ST segment elevation at admission, and significantly earlier regression of the ST segment elevation and appearance of coronary T waves were observed compared to QMI patients. In addition to the significantly lower level of mean peak serum creatine kinase activity and the significantly lower incidence of pump failure during the acute phase, the incidences of in-hospital mortality and multivessel disease were significantly lower in the NQMI patients. With respect to acute-phase coronary angiographic features within 48 h after the onset, the rate of spontaneous opening of infarct-related vessels was significantly higher in the NQMI patients. Thirteen of the 19 NQMI patients responded to urokinase infusion. These facts suggest that transient, intermittent or incomplete obstruction may favor this type of NQMI over QMI, and that thrombus might be an important factor in the pathogenesis of this type of NQMI.
伴有R波消退且无ST段压低的急性非Q波心肌梗死（NQMI）的临床特征与急性Q波心肌梗死（QMI）不同。NQMI患者入院时表现为ST段抬高，与QMI患者相比，观察到ST段抬高的消退显著更早且出现冠状T波。除急性期平均血清肌酸激酶峰值活性水平显著较低以及泵衰竭发生率显著较低外，NQMI患者的院内死亡率和多支血管病变发生率也显著较低。关于发病后48小时内的急性期冠状动脉造影特征，NQMI患者梗死相关血管的自发开通率显著更高。19例NQMI患者中有13例对尿激酶输注有反应。这些事实表明，短暂、间歇性或不完全阻塞可能使这种类型的NQMI比QMI更易发生，并且血栓可能是这种类型NQMI发病机制中的一个重要因素。
