标题：急性心肌梗死并发心脏破裂27例临床分析

      作者：梁伟杰，张在勇，黄惠敏，李健豪，张稳柱
    (广州市番禺区中心医院心血管内科，广东 广州 511400)

      卷次： 2014年25卷11期

      【摘要】 目的 探讨急性心肌梗死(AMI)患者出现心脏破裂(CR)的发病特点。方法 回顾性分析自2006年1
月至2012年9月我院收治的1 627例AMI患者，根据是否合并CR分为CR组(27例)和对照组(1 600例)。结果 CR
组患者年龄高于对照组(P<0.05)，女性发生率明显高于男性(P<0.01)；CR组就诊时初测收缩压高于对照组
(P<0.05)，血肌酐水平明显高于对照组(P<0.01)；CR组患者的心肌梗死部位多发生在前壁(18/27)；成功再灌注者
CR发生率明显少于未成功灌注者(P<0.05)。结论 高龄、女性、入院时血压升高、血肌酐水平升高、急性前壁尤
其是广泛前壁心梗、未成功再灌注是CR发生的危险因素。尽早血运重建，合理应用β受体阻滞剂和RAAS系统
拮抗剂，有利于减少CR的发生。

      【关键词】 急性心肌梗死；心脏破裂；血肌酐；灌注；β受体阻滞剂；RAAS系统拮抗剂

      【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350（2014）11—1575—03


Clinical analysis of 27 cases of cardiac rupture in patients with acute myocardial infarction.
LIANG Wei-jie,
ZHANG Zai-yong, HUANG Hui-min, LI Jian-hao, ZHANG Wen-zhu. Cardiovascular Department, Central Hospital of
Panyu District of Guangzhou, Guangzhou 511400, Guangdong, CHINA

【Abstract】 Objective To analyze the characteristics of cardiac rupture (CR) in patients with acute myocar-
dial infarction (AMI). Methods 1 627 consecutive cases of AMI from January 2006 to September 2012 were select-
ed in this study. Patients were divided into CR group (27 cases with CR) and control group (1 600 cases without CR).
Results Patients in CR group were older than those in control group (P<0.05), and the incidence of CR in female was
significantly higher than that in male (P<0.01). The initial systolic pressure in CR group was higher than that in control
group (P<0.05) as well as the level of serum creatinine (P<0.01). AMI in CR group was mostly occurred in anterior wall
(18/27). Patients with successful reperfusion were significantly less likely to undergo CR (P<0.05). Conclusion Pa-
tients who were older，female，with higher initial systolic pressure or serum creatinine, with anterior infarction espe-
cially extensive anterior wall, or delayed repeffusion were more likely to undergo CR. Early reperfusion，reasonable
application of beta blockers and RAAS antagonist could reduce the incidence of CR．

      【Key words】 Acute myocardial infarction; Cardiac rupture; Serum creatinine; Perfusion; Beta blockers; RAAS