急性心梗溶栓再通后ST段再抬高3例分析  

ST segment re-elevation after acute myocardial infarction recanalization:analysis of 3 cases

作　　者：朱建钢 

机构地区：[1]江苏省苏州金阊医院,江苏苏州215008

出　　处：《转化医学电子杂志》2015年第4期7-8,10,共3页E-Journal of Translational Medicine

摘　　要：目的：观察和分析急性心梗溶栓再通后ST段再抬高的临床特点。方法：选取2010-12/2014-12间我院收治的完成静脉溶栓治疗的急性心肌梗死患者48例作为临床研究对象。观察和分析患者冠状动脉再通情况和ST段抬高情况。结果：本组48例急性心肌梗死患者中，共有29例患者的血管再通，再通率为（60.42%），其中有3例患者在溶栓治疗结束之后0~40 min后再次发生ST抬高现象，ST段抬高程度为0.4~1.1 mV，发病距离静脉溶栓治疗的时间为2.0~6.0 h，其中2例患者ST再抬高时伴有胸痛症状加剧情况。经冠状动脉造影检查结果显示，3例ST段再抬高患者的梗死相关血管均完全再通（100%）。其中梗死相关血管包括左前降支近端病变1例，狭窄程度为65~85%；左前降支中段病变1例，狭窄程度为70~85%；右冠状动脉中段1例，狭窄程度为75~90%。冠状动脉血流监测显示，TIMI2级1例，TIMI3级2例。结论：急性心肌梗死溶栓再通后出现ST段再抬高现象可以作为心肌再灌注成功的重要指标。AIM： To observation and analysis clinical characteristics of ST-segment re-elevation after acute myocardial infarction （AMI） recanalization. METHODS： Choose 48 cases with AMI treated with completion of intravenous thrombolytic therapy from 2012 to 2014 in our hospital as the clinical research object. Observe and analyze the coronary artery recanalization and ST segment re-elevation of patients. RESULTS： 48 cases of AMI patients, there were 29 cases of patients with vascular recanalization, recanalization rate was 68.18%, including 3 cases of patients ST segment re-elevation phenomenon occurred again in 0~40 min after thrombolytic therapy, ST segment was 0.4~1.1mV, and the time between the incidence and venous thrombolytic therapy was 2.0~6.0 h. Besides, the 2 patients with ST segment re-elevation accompanied aggravated chest pain symptoms. The results of coronary angiography showed that the infarction related artery in 3 cases of ST segment re-elevation were complete recanalization （100%）. The infarct related vessels including proximal lesions of left anterior descending （LAD） in 1 cases, the stenosis degree of 65~85%, the middle lesions of LAD in 1 cases, the stenosis degree of 70~85%, 1 cases of middle of right coronary artery, stenosis degree of 75~90%. The coronary artery blood flow monitoring showed 1 cases of TIMI2, 2 cases of TIMI3. CONCLUSION： The phenomenon of ST segment re-elevation after thrombolytic recanalization in patients with AIM can be used as an important indicator of the success of myocardial reperfusion.

关 键 词：急性心肌梗死 静脉溶栓治疗 ST段 临床特点 

分 类 号：R542.22[医药卫生—心血管疾病]