急性心肌梗死经皮冠状动脉介入治疗后心电图ST段下降幅度与近期预后的观察  

Relations between ST-segment resolution and lately prognosis in patients with acute myocardial infarction and treated by primary percutaneous coronary intervention

作　　者：杨剑峰[1] 张荣林[2] 徐标[2] 宋杰[2] 

机构地区：[1]徐州市第一人民医院心内科,江苏徐州221002 [2]南京大学医学院附属鼓楼医院心脏中心,江苏南京210008

出　　处：《临床荟萃》2006年第15期1072-1074,共3页Clinical Focus

基　　金：江苏省重大医学应用示范工程项目"心脑血管病规范化治疗"

摘　　要：目的探讨急性心肌梗死急诊经皮冠状动脉介入治疗(PC I)后心电图ST段下降幅度与患者近期预后的关系。方法将急诊PC I术成功后1小时的18导联心电图(ECG)与入院当时ECG比较,分别测定梗死相关导联最大ST段高度,按抬高的ST段下降幅度分为A组:ST段下降≥50%,B组:ST段下降<50%,根据对影响患者近期预后相关因素的观察进行比较。结果两组患者在非致死性心脏事件、室壁运动异常、再通后ST段下降又再抬高和住院死亡病例方面差异无统计学意义(P>0.05),在左心室射血分数(LVEF)方面差异有统计学意义(P<0.05)。结论急性心肌梗死患者经急诊PC I术后,其心电图ST段下降幅度可以作为预示患者近期预后的一个临床实用指标,并进一步指导临床治疗。Objective To study the relations between ST-segment resolution and lately prognosis in patients with acute myocardial infarction（AMI） and treated by primary percutaneous coronary intervention（PCI）. Methods The electrocardiogram（ECG） result before PCI and one hour after PCI, ST-segment elevation of infarct-related lead of 18 lead ECG before and after PCI were evaluated. The patients were classified into two groups according to ST-segment resolution.group A, ST-segment resolution ≥50%; group B, ST-segment resolution 〈50%. The related factors affecting ST-segment resolution were analyzed and the related factors that affected lately prognosis in patients with acute myocardial infarction（AMI） and treated by primary percutaneous coronary intervention were observed. Results There is no difference in indeadly cardiac event wall motion abnormality, re-elevation of ST-segment after resolution, death in hospital in the two group. Obvious differences were discovered in left ventricular ejection fraction（LVEF）. Conclusion ST-segment resolution could be used to predict lately prognosis and instruct clinical therapy in patients with AMI and treated by PCI.

关 键 词：心肌梗塞 血管成形术 经腔 经皮冠状动脉 心电描记术 

分 类 号：R542.22[医药卫生—心血管疾病]