早期T波倒置对判断梗死相关动脉开通的临床价值  

The clinical value of early T wave inversion in determining the patency of infarct related arteries

作　　者：李瑞杰[1] 胡大一[1] 杨新春[1] 郭成军[1] 商丽华[1] 贾三庆[1] 李田昌[1] 郭晋萍[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院心脏中心,100020

出　　处：《中华心律失常学杂志》2000年第2期123-125,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　探讨急性心肌梗死 (acute myocardial infarction,AMI)早期 T波倒置对判断梗死相关动脉开通的临床价值。　方法　对发病≤ 6 h的 6 1例 (男性 46例、女性 15例 ,年龄 39～ 80岁 ) AMI患者以动态心电图持续 2 4h监测 T波变化 ,并与冠状动脉造影结果作对照。　结果　再灌注治疗患者 ,再灌注后 T波正向振幅显著降低同时呈现 T波倒置并逐渐加深 ,其中溶栓治疗成功的 2 4例于发病的 2～ 30 (8.6± 7.4) h、距再灌注 0～ 2 2 (3.5± 6 .3) h均显现 T波倒置 ,接受直接经皮腔内冠状动脉成形术治疗的 2 2例于发病的 2～ 11(5 .9± 2 .5 ) h、距再灌注 0～ 9(1.9± 2 .7) h均显现 T波倒置。而 15例梗死相关动脉未开通患者在监测期间 T波多正向 ,仅 2例见 T波倒置。　结论　 AMI患者 T波倒置的早期出现 ,对判断梗死相关动脉开通有较高的敏感性和特异性。Objective To evaluate the clinical value of early T wave inversion in determining the patency of infarct related arteries(IRA). Methods Sixty one patients(46 males and 15 females,ages 39～80)with acute myocardial infarction(AMI)underwent 24 hour Holter monitoring within 6 hours from the onset of the symptoms.The T wave changes were compared with the results of coronary angiography.Results In the patients who had successful reperfusion the upright amplitude of T wave became lower obviously and earlier T wave inversion after reperfusion was observed,while in those who had occluded IRA the upright amplitude of T waves were still higher and fewer cases had early T wave inversion.Conclusion The early T wave inversion after intervention in AMI had both high sensitivity and specificity in predicting the patency of IRA.

关 键 词：急性心肌梗塞 动态心电图 T波倒置 

分 类 号：R542.22[医药卫生—心血管疾病]