急性心肌梗死延迟PCI对心电图评估梗死范围的影响  

The infarct size eveluated by electrocardiogram for delayed PCI in acute ST-segment elevation myocardial infarction

作　　者：曹邦明[1] 刘同库[2] 王人彭[1] 骆秉铨[1] 

机构地区：[1]江苏徐州市第三人民医院心内科,221005 [2]吉林省北华大学医学院附属医院心内科,132000

出　　处：《临床心电学杂志》2008年第1期22-24,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨急性心肌梗死延迟PCI对心电图评估梗塞范围的影响。方法129例ST段抬高性急性心肌梗死患者,42例接受延迟PCI,21例接受紧急PCI,26例尿激酶静脉溶栓,40例内科药物保守治疗,对所有患者随访6-18个月。分别于围手术期1周内、静脉溶栓或内科药物保守治疗1周内,2周,1月及随访期内以Nancy B.Hindman提出的54项标准32分制的QRS记分系统评估梗死范围(infarct size,IS)。结果延迟PCI、紧急PCI、静脉溶栓使心电图评估梗死范围回缩大于保守治疗(p<0.05)。延迟PCI、紧急PCI使梗死范围回缩无显著差异(p>0.05),均大于静脉溶栓,但与静脉溶栓比较未达到显著性差异(p>0.05)。前壁梗死范围回缩大于下壁(p<0.05)。结论延迟PCI可使54项标准32分制QRS记分系统评估梗死范围回缩,回缩率大于保守治疗。前壁心肌梗死范围回缩大于下壁。Objective To evaluate the infarct size by electrocardiogram for delayed PCI in acute ST-segment elevation myocartial infarction. Methods one hundred and twenty-nine patients with AMI and with ST- segment elevation,twent-one patients were treated by urgent PCI ,fouty-two patients were treated by delayed PCI, twenty-six patients wen treated by intravenous thrombolytic therapy,fouty patients were treated by physical medical conservative therap,. The 54-criteria/32-point systerm proposed by Nancy B.Hindman was used to estimate the infarct size（IS）. The muximum was recorded during the first perioperative week and within one week for the thrombolytic therapy group is well as the physical medical conservative therapy group. Recorder was alse made in the two weeks,one month and in the follow-up period. Results There is a greater decrease in median QRS score- estimated AMI size betw,en initial and follow-up electrocardiograms in delayed PCI,urgent PCI and thrombolytic therapy groups than the physical medical conservative therapy group （p〈0.05）.While the decrease difference is not apparent between the lelayed PCI and ergent PCI group （p〉0.05）,both groups have greater decrement in the QRS- estimated infarct size, though the difference is not significant （p〉0.05）.The decrement in the QRS-estimated AMI size is more for anterior wall than for inferior wall （,0〈0.05）. Conclusion Delayed PCI can decrease the myocardial infarct size based on the the 54-criteria/32-point systerm more than the physical medical conservative therapy. The decrement in the QRS-estimated AMI size is more for anterior wall than for inferior.

关 键 词：QRS记分 梗死范围 急性心肌梗死 延迟PCI 

分 类 号：R542.22[医药卫生—心血管疾病]