探讨急性ST段抬高型心肌梗死（STEMI）部位及冠脉病变对心衰、心律失常的影响，以及心衰,心律失常与冠脉病变程度的关系。
ToexploreinfluenceofpositionofmyocardialinfarctionandcoronaryarterylesionsinpatientswithacuteSTelevationmyocardialinfarction(STEMI),andtherelationshipamongheartfailure,arrhythmiaandseverityofcoronaryarterylesion.回顾性分析年1月至年6月因STEMI于我院住院治疗并行冠脉造影的患者例的临床资料。收集患者一般临床资料，应用SYNTAX积分反映冠状动脉病变程度，对SYNTAX积分与心衰,心律失常的关系进行分析。
Clinicaldataofpatients,whohospitalizedinourhospitalbecauseofSTEMIandreceivedcoronaryangiographyfromJantoJun,wereretrospectivelyanalyzed.Generaldataofpatientswerecollected,andSYNTAXscorewasusedtoreflectseverityofcoronaryarterylesion,andtherelationshipamongheartfailure,arrhythmiaandSYNTAXscoreswereanalyzed.从中发现，梗死相关动脉（IRA）为左前降支(LAD)和/或左主干(LM)的患者心衰发生率明显高于右冠脉(RCA)患者（57.0%比39.7%，P=0.），IRA为RCA的患者心律失常发生率明显高于LCX的患者（37.0%比6.3%，P=0.）；梗死部位为下壁/右室患者的心律失常发生率(48.4%)、休克发生率(54.8%)最高,明显高于其他部位,P0.05或0.01。心衰、心律失常患者SYNTAX积分明显高于非心衰，非心律失常患者[(18.7±9.1)分比(15.4±8.6)分、(19.7±9.0)分比(16.1±8.8)分，P均0.01]。
Incidencerateofheartfailureinpatientswithinfarctionrelatearteryleftanteriordescendingartery(LAD)AND/orleftmaincoronaryartery(LM)wassignificantlyhigherthanthatofpatientswithrightcoronaryartery(RCA)(57.0%vs.39.7%,P=0.),incidencerateofarrhythmiainpatientswithRCAwassignificantlyhigherthanthatofpatientswithleftcircumflexartery(LCX)(37.0%vs.6.3%,P=0.);incidenceratesofarrhythmia(48.4%),shock(54.8%)werehighestinpatientswithinferiorwall/rightventriclethanthoseofotherposition,P0.05or0.01.SYNTAXscoresinpatientswithheartfailureandarrhythmiaweresignificantlyhigherthanthoseofpatientswithoutheartfailureandarrhythmiarespectively[(18.7±9.1)scoresvs.(15.4±8.6)scores,(19.7±9.0)scoresvs.(16.1±8.8)scores,P0.01both].实验结果可知STEMI患者心力衰竭、心源性休克及心律失常的发生率与冠脉病变部位、程度,心肌梗死部位有关。
Incidenceratesofheartfailure,cardiogenicshockandarrhythmiaarerelatedtocoronaryarterylesionspositionanddegreeandmyocardialinfarctionpositioninSTEMIpatients.作者：陈明光，关瑞锦，吴志勇，林风辉
单位：福建医科大学省立临床医学院/医院重症医学四科
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