肖栋,许利冬,李俭强,薛竟宜,李为民

• 1:哈尔滨医科大学附属第一医院心内科

摘要(Abstract)：

目的探讨左冠状动脉解剖形态与左主干(LM)急性心肌梗死(AMI)发生及住院期间死亡的关系。方法回顾性分析2010年1月至2015年4月于哈尔滨医科大学附属第一医院行冠状动脉造影证实左主干病变的176例患者的临床资料及冠状动脉造影资料,根据是否发生AMI分为LM-AMI组(43例)和LM非AMI组(非AMI组,133例),LM-AMI组根据住院期间死亡情况分为存活组(35例)和死亡组(8例)。利用定性比较分析(QCA)软件测量左冠状动脉解剖形态,采用单因素分析及Logistic回归分析,研究左冠状动脉解剖形态与LM-AMI发生及住院期间死亡的关系。结果 LM-AMI组患者左前降支(LAD)与左回旋支(LCX)夹角小于非AMI组(P<0.05),而LM直径及长度、LAD及LCX直径、LM与LAD夹角和LM与LCX夹角两组比较,差异均无统计学意义(均P>0.05);LAD与LCX夹角较小者LM-AMI的发生率明显增加,且LAD与LCX夹角<79.43°的患者发生LM-AMI的风险是LAD与LCX夹角为79.43°~108.73°患者的3.6倍。LM-AMI存活组与死亡组LM直径及长度、LAD及LCX直径、LM与LAD夹角、LM与LCX夹角及LAD与LCX夹角比较,差异均无统计学意义(均P>0.05)。结论LM病变患者LAD与LCX夹角与LM-AMI的发生相关,LAD与LCX夹角<79.43°是LM病变患者发生LM-AMI的独立危险因素,而左冠状动脉解剖形态与LM-AMI患者住院期间死亡无相关性。

关键词(KeyWords)： 冠状动脉;急性心肌梗死;左主干病变

Abstract:

Keywords:

基金项目(Foundation): 哈尔滨高层次人才基金(2013SYYRCYJ06)

作者(Author): 肖栋,许利冬,李俭强,薛竟宜,李为民

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