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[心肌梗死中的血栓栓塞与心脏破裂]

[Thormboembolisms and heart ruptures in myocardial infarct].

作者信息

Gritsiuk A I, Petrus' V G

出版信息

Kardiologiia. 1977 Feb;17(2):54-9.

PMID:758050
Abstract

An analysis of the incidence of thromboembolism and heart ruptures with reference to different causative factors was conducted on the basis of 585 patients dying of myocardial infarction during the recent 30 years (autopsy data) and 1417 patients with myocardial infarction (298 mortality cases among them) hospitalized during the recent 10 years. A reduction of the incidence of thromboembolism and an increase of the incidence of heart ruptures in the recent years were revealed. Thromboembolism and heart ruptures play an important role among the causes of mortality in myocardial infarction. The development of thromboembolism in myocardial infarction is favoured by the macro-focal nature of the heart lesion, repeated necroses of the myocardium, localization of infarction in the posterior and posteriolateral zones, old age of the patients (over 60), presence of diabetes mellitus and acute cardiac aneurysm. Thromboembolism occurs with the same incidence rate within the initial 7 days, and later during the acute phase. Thrombi are most often found in the cardiac cavities, pulmonary, renal and splenic vessels, in the cerebral, mesenteric and other vessels. Heart ruptures are favoured by the macro-focal nature of the cardiac lesion, localization of the infarction in the anterior and anteriolateral zones, old age (over 60), presence of acute cardiac aneurysm. Most frequently the ruptures are observed in primary myocardial infarction within the initial 5--7 days of the disease. The use of anticoagulants in myocardial infarction decreases the incidence of thromboembolic complications and heart ruptures.

摘要

基于近30年585例死于心肌梗死患者(尸检数据)以及近10年住院的1417例心肌梗死患者(其中298例死亡病例),针对不同致病因素对血栓栓塞和心脏破裂的发生率进行了分析。结果显示近年来血栓栓塞发生率降低,心脏破裂发生率升高。血栓栓塞和心脏破裂在心肌梗死死亡原因中起着重要作用。心肌梗死中血栓栓塞的发生受心脏病变的宏观灶性性质、心肌反复坏死、梗死位于后壁和后外侧区域、患者高龄(60岁以上)、糖尿病存在以及急性心脏动脉瘤的影响。血栓栓塞在发病最初7天内和急性期后期的发生率相同。血栓最常出现在心腔、肺、肾和脾血管、脑、肠系膜和其他血管中。心脏破裂受心脏病变的宏观灶性性质、梗死位于前壁和前外侧区域、高龄(60岁以上)、急性心脏动脉瘤的影响。最常发生在疾病最初5 - 7天内的原发性心肌梗死中。心肌梗死中使用抗凝剂可降低血栓栓塞并发症和心脏破裂的发生率。

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