CAJ | 학술논문

目的：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。方法：回顾性分析2009年1月至2011年6月因STEMI于我院住院治疗并行冠脉造影的患者224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。结果：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＝0.017）， 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＝0.016）；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， P＜0.05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]。结论：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。
목적：탐토급성ST단태고형심기경사（STEMI）부위급관맥병변대심쇠、심률실상적영향，이급심쇠，심률실상여관맥병변정도적관계。방법：회고성분석2009년1월지2011년6월인STEMI우아원주원치료병행관맥조영적환자224례적림상자료。수집환자일반림상자료，응용SYNTAX적분반영관상동맥병변정도，대SYNTAX적분여심쇠，심률실상적관계진행분석。결과：경사상관동맥（IRA）위좌전강지（LAD）화／혹좌주간（LM）적환자심쇠발생솔명현고우우관맥（RCA）환자（57.0％비39.7％， P＝0.017）， IRA위RCA적환자심률실상발생솔명현고우LCX적환자（37.0％비6.3％， P＝0.016）；경사부위위하벽／우실환자적심률실상발생솔（48.4％）、휴극발생솔（54.8％）최고，명현고우기타부위， P＜0.05혹＜0.01。심쇠、심률실상환자SYNTAX적분명현고우비심쇠，비심률실상환자[（18.7±9.1）분비（15.4±8.6）분、（19.7±9.0）분비（16.1±8.8）분，P균＜0.01]。결론：STEMI환자심력쇠갈、심원성휴극급심률실상적발생솔여관맥병변부위、정도，심기경사부위유관。
Objective:To explore influence of position of myocardial infarction and coronary artery lesions in patients with acute ST elevation myocardial infarction (STEMI) ,and the relationship among heart failure ,arrhythmia and severity of coronary artery lesion .Methods :Clinical data of 224 patients ,who hospitalized in our hospital because of STEMI and received coronary angiography from Jan 2009 to Jun 2011 ,were retrospectively analyzed .General data of patients were collected ,and SYNTAX score was used to reflect severity of coronary artery lesion ,and the rela‐tionship among heart failure ,arrhythmia and SYNTAX scores were analyzed .Results:Incidence rate of heart fail‐ure in patients with infarction relate artery left anterior descending artery (LAD) AND/or left main coronary artery (LM) was significantly higher than that of patients with right coronary artery (RCA) (57.0% vs .39.7% , P=0.017) ,incidence rate of arrhythmia in patients with RCA was significantly higher than that of patients with left circumflex artery (LCX) (37.0% vs .6.3% , P=0.016);incidence rates of arrhythmia (48.4% ) ,shock (54.8% ) were highest in patients with inferior wall/right ventricle than those of other position , P<0.05 or <0.01.SYNTAX scores in patients with heart failure and arrhythmia were significantly higher than those of patients without heart failure and arrhythmia respectively [ (18.7 ± 9.1) scores vs .(15.4 ± 8.6) scores ,(19.7 ± 9.0) scores vs .(16.1 ± 8.8) scores , P<0.01 both] .Conclusion:Incidence rates of heart failure ,cardiogenic shock and arrhythmia are related to coronary artery lesions position and degree and myocardial infarction position in STEMI patients .