急性短期冬眠心肌心电图的变化  

Experimental study on electrocardiogram-changes of acute short-term hibernating myocardium

作　　者：贺威琼 陈士良[2] 贾国良[2] 

机构地区：[1]沈阳军区第202医院干部病房,沈阳110003 [2]第四军医大学西京医院心内科

出　　处：《临床心血管病杂志》2000年第5期227-229,共3页Journal of Clinical Cardiology

摘　　要：目的 :观察急性短期冬眠心肌 (HM)心电图 (ECG)变化 ,并探讨其临床意义。方法 :利用 9只在体犬心脏 ,用微米缩窄器造成冠状动脉有意义狭窄制作短期 HM模型。观察其狭窄不同部位、不同时间点的 ECG变化。结果 :当左前降支 (LAD)狭窄时 ,5只犬心表面 ECG ST段均抬高 ,在狭窄 1 5min时抬高显著 (P <0 .0 5) ,同时伴有 T波倒置 ;左旋支 (LCX)狭窄时 ,2只犬 ECG示 ST段下移 (50 % ) ,狭窄 30 min时下移显著 (P <0 .0 1 ) ,另 2只犬为 ST段抬高 (50 % )。结论 :体表 ECG胸导联 ST段抬高是犬 LAD狭窄急性缺血的敏感指标 ,T波倒置可作为评估 HM的一种标志 ,为不稳定型心绞痛患者选择冠状动脉旁路移植术、经皮腔内冠状动脉成形术 。Objective:Through establishing shortterm hibernating myocardium(HM),the HM and reversible myocardial dysfunction could be further recognized.Method:Shortterm hibernating myocardium models were set up from significant stenosis of coronary artery which was induced by micrometer constrictors placed in the hearts of 9 dogs,to observe the ECG changes on their different sites and various time periods.Result:When the left anterior descending artery (LAD) was narrowed,all of the surface ECG ST segments of 5 of the dogs were elevated;when the LAD had narrowed for 15 minutes,the elevations would show the maximal amplitude (P< 0.05 ) and simultaneously inverted T was accompanied;when the left circumflex artery (LCX) was narrowed,the surface ECG ST segments of 2 of the dogs were depressed (50%);when LCX had narrowed for 30 minutes,the depressions of the 2 dogs became obvious (P< 0.01 ),but those of the rest 2 dogs were elevated (50%).Conclusion:The ST elevation in the precordial leads may be regarded as a sensitive marker of LAD stenosis and acute ischemia in dog,and the inverted T may be used as one of the indices to evaluate the HM.The study may offer UA patients a simple and effective mothod in choosing CABG、PTCA as well as in improving myocardial dysfunctions.

关 键 词：心肌缺血 急性冬眠心肌 心电图 HM 

分 类 号：R542.204[医药卫生—心血管疾病] R540.41[医药卫生—内科学]