非梗死相关动脉狭窄对急诊介入术后ST段抬高心肌梗死患者心室跨壁复极离散度的影响  

Influence of non-infarction-related artery stenosis on transmural dispersion of repolarization in STEMI patients after PCI

作　　者：姚青海[1] 吴尚勤[1] 孙姗[1] 杨琦[1] 程爱娟[1] 丁军[1] 陈炳伟[1] 李鹏[1] 杨培根[1] 

机构地区：[1]天津市胸科医院心内七科,300051

出　　处：《中华老年心脑血管病杂志》2011年第4期333-335,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨非梗死相关动脉(IRA)的不同程度病变对急诊PCI术后急性ST段抬高心肌梗死(STEMI)患者心室跨壁复极离散度(TDR)的影响。方法选择STEMI患者341例,经急诊PCI再通者212例(再通组),未能实现IRA再通者129例(非再通组)。再通组患者又根据IRA狭窄程度分为单支病变组(104例)和多支病变组(102例),除外6例狭窄等于50%患者。另选健康体检者36例(对照组)。以校正的T波顶点至终点时间(Tp-e/c,Tp-e/RR^(1/2))作为TDR的量化指标。比较术后不同时间单支病变组与多支病变组患者Tp-e/c降幅和降幅百分比。结果非再通组患者入院时Tp-e/c值明显大于对照组,差异有统计学意义(P<0.01)。与入院即刻比较,单支病变组患者术后Tp-e/c明显降低(P<0.01),且术后第3天较第2天明显下降(P<0.05);多支病变组患者术后Tp-e/c明显降低(P<0.01),术后3天内Tp-e/c无显著改变(P>0.05)。结论急诊PCI能有效降低STEMI患者发病早期的TDR,且改善效果与IRA的病变程度无关。Objective To study the influence of different stenoses of non-infarction-related artery on transmural dispersion of repolarization（TDR） in ST elevated myocardial infarction（STEMI） patients after primary PCI. Methods 841 STEMI patients were divided into revaseularized group （n =212） and unrevascularized group （n = 129） according to whether successful reperfusion was accomplished after PCI. The patients in revascularized group were further divided into single-vessel group（104 cases） and multiple-vessel group（102 cases）. Other 6 patients with moderate lesions（50%） were excluded. Thirty-six healthy persons without coronary heart disease were selected to serve as control group. Tp-e （in present study Tp-e was corrected and Tp-e/ RR1/2 ,Tp-e/c were adopted） was used as quantitation index of TDR. Decrease and decrease per- centage of Tp-e/c were measured at different time points after operation and were compared between single vessel group and multiple-vessel group. Results Tp-e/c of patients in unrevascularized group was much higher in comparison with control group on admission （P〈0.01）. Tp-e/c of both single-vessel group and multiple-vessel group after operation was significantly reduced as compared with the values measured before operation （P〈0.01）. In single-vessel group, Tp-e/c was decreased on third day in comparison with the value measured on the second day （P〈 0.05）. Conclusion Primary PCI can effectively reduce TDR in STEMI patients no matter how serious the stenosis is in non-infarction related artery.

关 键 词：冠状动脉狭窄 心肌梗死 急症 体表电位图 心律失常 心性 

分 类 号：R542.22[医药卫生—心血管疾病]