心筋梗塞の発症の余地と予防に関与する要因の研究
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概要
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With the alarming increase in the development of myocardial infarction, primary prevention of coronary heart disease, especially prospective or retrospective study on coronary risk factors, has been considered to be of increasing importance. In order to elucidate the predictable factors of the occurrence of acute myocardial infarction, the history and laboratory findings of 107 patients with acute myocardial infarction, in whom observation had been performed on factors prior to the onset of AMI, were analyzed and compared with those in 106 patients with angina pectoris and 510 controls. The results obtained were as follows ; 1) The incidence of hyperlipidemia, hypertension, abnormalities in ST and T changes, prolongation of QTc for more than 0.45 second, amplitude of SV_1 plus RV_5 of more than 40mm and enlargement of CTR of more than 0.55 were significantly higher in AMI than in controls. 2) The incidence of hyperlipidemia, prolongation of QTc, abnormalities of ST and T, SV_1 plus RV_5 were significantly higher in AMI than in angina pectoris. 3) The patients with AMI had more multiple factors, as compared with angina pectoris and control. 4) The incidence of chest pain prior to the onset of AMI was observed in 63.8% of cases and this was significantly higher than no chest pain before the onset. The initial symptom appeared within 6 months before the onset of AMI. 5) The incidence of hyperlipidemia and the prolongation of QTc were higher in patients with AMI during the period of teratment as unstable angina pectoris than in patients without AMI. 6) Hypertension was a coronary risk factor, but it could not be considered as a direct cause of AMI. 7) It is highly possible that if the anginal attack changes form effort type to at reat or at rest with effort type, myocardial infarction developes during the course of it. From these results, it is highly probable that hyperlipidemia, enlargement of CTR and prolongation of QTc in addition to hyperlipidemia, hypertension, cigarette smoking, diabetes mellitus, obesity and family history are of great importance in AMI. Fruthermore, the reliability of predicting AMI is considered to be increased, when the pattern of anginal attack and type are considered.
- 神戸大学の論文