急性心肌梗死经皮腔内冠脉介入治疗后T波改变的临床意义  

Clinical Assessment of T Wave Changes in Patients with Acute Anterior Myocardial Infarction after Percutaneous Coronary Intervention

作　　者：张云[1] 黄文珠[1] 许端敏[1] 陈畅[1] 

机构地区：[1]汕头大学医学院第一附属医院心内科,广东省汕头市505041

出　　处：《中华全科医学》2013年第2期179-180,共2页Chinese Journal of General Practice

基　　金：广东省科学技术厅基金资助项目(2010B031600274)

摘　　要：目的探讨急性前壁心肌梗死患者急诊直接经皮腔内冠状动脉介入治疗(Percutaneous Coronary intervention,PCI)后T波变化的临床意义。方法 70例急性ST段抬高型前壁心肌梗死患者,行急诊直接PCI术,术前及术后1 h,24h记录心电图,24 h内T波倒置者为T波倒置组,T波未倒置者为T波未倒置组,并观察两组患者住院期间心血管事件发生情况,用三维超声心动图分别于PCI术后1个月、6个月检测两组病例,左室射血分数(LVEF%)及左室舒张末期内径(LVEDd),进行比较。结果 PCI术后24 h内T波倒置55例(78.6%),其中50例(90.9%)伴1 h内ST段快速回落≥50%,T波未倒置15例(21.4%),其中5例(33.3%),伴ST段快速回落,两者比较差异有统计学意义(P<0.01),T波未倒置组并发心血管不良事件发生率高于T波倒置组;PCI术后1个月及6个月的左心室功能比较,差异有统计学意义,P<0.05。结论急性前壁心肌梗死行PCI术后早期T波倒置,预示预后及心功能较好。Objective To explore the clinical significance of T wave changes in patients with acute anterior myocardial in-farction after the percutaneous coronary intervention（PCI）. Methods The emergency PCI was performed in 70 patients with a-cute anterior myocardial infarction that were with ST elevation. The electrocardiogram monitoring was recorded 1 hour and 24 hours before and after the operation. The patients were divided into T wave inversion group（T wave inverted in 24 hours） and non T wave inversion group（ without T wave inversion in 24 hours）. LVEF% and LVEDd were detected with three-dimensional color echocardiography at 1 month and 6 months after PCI operation. Results T wave inverted group has 55 patients （78.6%） in which 50 ones （90.9%） fall rapidly with ST segment within one hour;the other group has 15 （21.4% ） ,5 in which （33.3 % ） fall rapidly. The rate of adverse cardiovascular events in non T wave inversion group was significantly higher than that in T wave group （P 〈0.01 ）. The difference in LVEF% and LVEDd at 1 month and 6 months after PCI operation was significantly between the two groups （P 〈 0.05 ）, Conclusion The early T wave inversion after PCI for acute anterior myocardial infarction is associated with better myocardial reperfusion and better cardiac function.

关 键 词：急性心肌梗死 经皮腔内冠脉介入 冠脉再通 T波倒置 

分 类 号：R542.22[医药卫生—心血管疾病] R541.4[医药卫生—内科学]