急性ST段抬高心肌梗死患者直接PCI前后Tp-e/QT变化及ST段回落对预后的影响  

Effects of Tp-e/QT change and a declined in ST segment on prognosis in patients with acute ST-segment elevation myocardial infarction after direct PCI

作　　者：张晓丹[1] 赵红丽[1] 李潞[1] 于淼[1] 

机构地区：[1]沈阳医学院沈洲医院心内科,110002

出　　处：《实用医学杂志》2013年第17期2812-2814,共3页The Journal of Practical Medicine

基　　金：沈阳市高新技术产业发展与科技攻关计划-社会发展科技攻关专项项目(编号:F11-262-9-18);辽宁省科学技术计划项目(编号:2010225036)

摘　　要：目的:观察急性ST段抬高心肌梗死(STEMI)患者直接PCI前后Tp-e/QT变化及ST段回落对临床预后的预测价值。方法:选择首次因STEMI行直接PCI患者137例,监测PCI术前及术后12 h常规12导联同步体表心电图,进行Tp-e/QT测量及ST段回落分析,随访12个月,观察主要不良心血管事件(MACE),以发生MACE为因变量采用Logistic回归模型行多因素分析。结果:与△3<25%组相比,△3≥25%组前壁心肌梗死比例较高,症状开始至再灌注时间长(P<0.05)。随访结束累计发生7例MACE(5.11%),在无ST段回落组发生率明显高于ST段回落组(16.1%vs 1.9%,P<0.05)。结论:急性STEMI患者行直接PCI治疗前后Tp-e/QT变化显著与前壁心肌梗死、症状开始至再灌注时间延长有关;无ST回落为发生远期MACE的独立危险因素。Objective To explore the value of Tp-e/QT change and a decline in ST segment in the prediction of prognosis in patients with acute ST-segment elevation myocardial infarction （STEMI） after direct PCI. Methods 137 patients undergoing direct PCI for STEMI were included in this study. 12-lead synchronous ECG were monitored before and 12 h after PCI. Tp-e/QT was measured and the decline in ST segment was analyzed. During a follow-up of 12 months, major adverse cardiovascular events （MACE） were observed. Multivariate Logistic regression models with MACE as dependent variable was used for analysis of multiple factors. Results As compared with A 3〈25% group, a higher proportion of anterior wall myocardial infarction occurred in A 3 〉 25% group, and the time from onset of symptoms to reperfusion was longer （P 〈 0.05）. At the end of follow-up, MACE developed in 7 （5.11% ） patients, and the rate of MACE was significantly higher in the group of no decrease in ST segment than in the group of a decline in ST segment （ 16.1% vs. 1.9%, P 〈 0.05）. Conclusions The changes of Tp-e/QT before and after direct PCI are significantly associated with anterior wall myocardial infarction and with the prolonged time from onset of symptoms to reperfusion in patients with acute STEMI; no decline in ST segment is an independent risk factors for MACE.

关 键 词：心肌梗死 Tp—e QT比值 心电描记术 血管成形 经腔 经皮冠状动脉 

分 类 号：R542.22[医药卫生—心血管疾病]