持续监测ST段对评估急性心肌梗死早期梗死相关动脉动态变化的意义  

The value of continued ST segment monitoring in evaluation of dynamic changes of infarct related arteries in early phase of acute myocardial infarction

作　　者：胡大一[1] 李瑞杰[2] 郭成军[3] 郭晋萍[3] 贾三庆[4] 李田昌[5] 商丽华[5] 

机构地区：[1]北京大学人民医院心内科,首都医科大学附属北京同仁医院心内科,100044 [2]北京市垂杨柳医院心内科 [3]北京安贞医院心内科 [4]北京友谊医院心内科 [5]首都医科大学附属北京同仁医院心血管疾病防治中心

出　　处：《中华心血管病杂志》2001年第5期277-279,共3页Chinese Journal of Cardiology

摘　　要：目的　持续监测ST段变化评估急性心肌梗死 (AMI)早期梗死相关动脉 (IRA)动态变化的意义。方法　对发病≤ 6h的 5 5例 (男 40例 ,女 15例 ,年龄 39～ 80岁 )AMI患者进行动态心电图监测 ,持续观察 2 4hST段变化并与冠状动脉造影结果作对照。结果　 (1)IRA未开通者ST段持续抬高并伴有逐渐下降趋势 ;(2 )溶栓疗法和直接经皮冠状动脉腔内成形术成功后ST段迅速下降并保持相对稳定 ;(3)所有患者 2 4h内均见有间断的ST段抬高和下降的波动性变化 ,尤其多见于溶栓成功早期。结论　AMI发病早期IRA处于动态的开放 关闭状态 ,持续监测ST段可较全面反应IRA变化。Objective To evaluate the dynamic changes of infarct related arteries (IRA) with continued monitoring of ST segment in early acute myocardial infarction (AMI). Methods Fifty five patients (40 males and 15 females, ages 39 80) with AMI underwent 24 hours Holter monitoring within 6 hours after the symptom onset. The changes of ST segments were observed continually and compared with the results of coronary arteries angiography. Results (1) In the patients who had occluded IRA, ST segments remained elevated with a tendency to decline; (2) In those who had successful reperfusion, ST segments came down rapidly after reperfusion and then kept stable; (3) Intermittent fluctuation of ST segments with elevation or decline was observed commonly during 24 hours in all patients, especially in the earlier time after successful thrombolysis. Conclusion A dynamic changes of IRA with opening occluding were showed in early AMI. The continued monitoring of ST segment can be used to evaluate the dynamic changes of IRA.

关 键 词：心肌梗塞 冠状动脉造影术 心电描记术 ST段 

分 类 号：R542.22[医药卫生—心血管疾病]