急性心肌梗死再灌注后心电图ST段回落不良的临床意义及远期预后影响  

Clinical significance and long-term prognosis of poor resolution of ST segment after reperfusion in acute myocardial infarction

作　　者：邱俊英[1] 彭清臻[1] 

机构地区：[1]湖北省孝感市中心医院,孝感432100

出　　处：《内科急危重症杂志》2013年第1期16-17,20,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨急性心肌梗死(AMI)再灌注后心电图ST段回落不良的临床意义及其对远期预后的影响。方法:156例AMI患者分别计算PCI术前及术后2hST段抬高相关导联的总和(ΣSTE),以后者ST段总和(ΣSTE)与前者相比,下降≥50%为ST段迅速回落(ST段迅速回落组)(n=124),下降<50%者为ST段回落不良(ST段回落不良组)(n=32)。同时观察患者术前、术后7d脑钠肽的变化,以及1年后心室重构的发生率。结果:ST段回落不良组患者脑钠肽明显增高且呈正相关,1年后心室重构的发生率明显增高。结论:AMI再灌注后心电图ST段回落不良患者血浆BNP明显增高,与心室重构密切相关,是AMI后心力衰竭发生的重要因素。Objective ： To investigate the clinical significance of poor resolution of ST segment after reperfusion in acute myocardial infarction （AMI） as well as its effect on the long-term prognosis. Methods ： Sum of ST segment elevation in in- farct-related leads （ Y STE） were calculated before and 2 hours after percutaneous coronary intervention （PCI） in 156 ca- ses with AMI. Sum ST （]~STE） after PCI was compared with that before PCI, resolution /〉 50% was tbund in 124 pa- tients, those 〈 50% were in 32 patients. Meanwhile, changes of brain natriuretic peptide （BNP） before PCI and 7 days after PCI, incidence of left ventricular remodeling after 1 year were observed. Results： BNP increased in patients with poor resolution of ST segment, and positively related to ventricular remodeling after 1 year. Conclusions ： BNP increased signifi- cantly in patients with poor resolution of ST segment after AMI reperfusion, and is closely related with the incidence of ven- tricular remodeling after 1 year. It is an important factor of developing heart failure after AMI.

关 键 词：急性心肌梗死 再灌注 ST段回落不良 

分 类 号：R543[医药卫生—心血管疾病]