| Object: The object of this study is the patients who have been diagnosedacute ST-elevated segment myocardial infarction and have spontaneousreperfusion of infarction related artery。We want to find out the clinicalcharacteristics of these patients and their short-term prognosis.Method: A sum of125consecutive patients with acute STEMI，who werehospitalized in the cardiovascular disease center of the first hospital of JilinUniversity between Aug1,2013and Oct31,2013, were enrolled. Also, thepatients must be given primary coronary angiography within12hours that thesymptom first appeared. Depending on the result of CAG, the patients weredivided into SR group (n=34), and NR group (n=91). Then we needed to inquirethe medical history in detail and recorded the time since the symptom firstappeared, whether did the patients have hypertension, diabetes mellitus, orsmoking. Then a physical examination would be carried out and the heartfunction of the patients would be classified. When the patients just admitted tothe CCU, the vein blood samples would be collected, then the complete bloodcount, urine routine, blood biochemistry, D-dimer, myocardial injury markers,B-type natriuretic peptide would be tested. On the second day of admission, thefasting blood samples would be collected, then test the serum lipid, lipoprotein a，blood glucose. All the patients would be given echocardiography, then recordthe ejection fraction and the left ventricular end-diastolic diameter. The majoradverse cardiac events would be recorded, included the death, heart failure,sustained ventricular tachycardia, ventricular fibrillation, Ⅲ degreeatrioventricular block.Result:(1)The incidence of spontaneous reperfusion of the infarctionrelated artery in all the acute STEMY patients is27.2%, there is not difference ingender, age, the time since symptom onset, area of infarction, hypertension,diabetes mellitus, and smoking between the SR group and NR group. The heartfunction of patients on admission in SR group is better than the NR group, butthe difference has no statistical significance.(2)The frequency of LAD asinfarction related artery in SR group is higher than the NR group,67.7%vs47.3%, p=0.042.(3)The EFs of two groups are respective52.23±6.41%vs49.90±7.36%(p=0.121), but the difference has no statisticalsignificance. The serum creatinine of two groups is respective69.62±14.77μmol/L vs83.08±43.07μmol/L (p=0.049);the lipoprotein a of two groups aredifferent, are respective0.23±0.16mg/L vs0.30±0.33mg/L(p=0.048).The othertests, include D-dimer, B-type natriuretic peptide, serum lipid, blood glucose,blood urea nitrogen, platelet, write blood cell, red blood cell, hemoglobin, haveno difference.（4）The NR group has28cases of MACE, include5cases ofdeaths,16cases of heart failure,4cases of sustained ventricular tachycardia,1case of ventricular fibrillation,2cases of Ⅲ degree atrioventricular block. The incidence is30.8%. In SR group, there are3cases of MACE, include2cases ofheart failure,1case of sustained ventricular tachycardia. The incidence is8.8%.There is statistical significance in two groups.（p=0.011）Conclusion: The spontaneous reperfusion of IRA in the patients with AMIis a common clinic phenomenon. This kind of patients has no markedlycharacteristics in the routine blood biochemistry. The patients with spontaneousreperfusion often have a lower value of serum creatinine on admission, oftenhave a lower incidence of MACE in hospitalization and have a better prognosis. |
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