急性心肌梗死冠状动脉介入治疗后心电图ST段回落与心肌组织灌注的观察  

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

作　　者：杨剑峰[1] 王相智[1] 张鸿举[1] 

机构地区：[1]江苏省徐州市第一人民医院心内科,江苏徐州221002

出　　处：《海南医学》2008年第3期16-17,共2页Hainan Medical Journal

摘　　要：目的探讨急性心肌梗死急诊经皮冠状动脉介入治疗(PCI)再通后心电图ST段下降幅度与心肌组织灌注的关系。方法将PCI再通后1小时的18导联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ST段回落和心肌水平有效再灌注相关临床因素的观察而进行比较。结果两组患者在非致死性心脏事件、LVEF、室壁运动异常和住院死亡病例方面差异有统计学意义(P<0.05),A组患者心肌水平有效再灌注明显好于B组。结论急性心肌梗死经急诊PCI再通后心电图ST段回落程度可以预示心肌水平有效再灌注,井进一步指导临床治疗。Objective To study the relations between ST-segment resolution and myocardial tissue perfusion in patients with acute myocardial infarction（AMI） and treated by primary percutaneans 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 myocardial tissue perfusion in patients with acute myocardial infarction（AMI） and treated by primary percutaneous coronary intervention were observed. Results Obvious differences were discovered in indeadly cardiac event, left ventricular ejection fraction （LVEF）, wall motion abnormality, death in hospital in the two group. The patients in group A had better myocardial tissue perfusion than those of group B. Conclusions ST-segment resolution could be used to predict myocardial tissue perfusion and instruct clinical therapy in patients with AMI and treated by PCI.

关 键 词：心肌梗死 冠状动脉介入治疗 ST段 心肌再灌注 

分 类 号：R542.2[医药卫生—心血管疾病]