急性心肌梗死经皮腔内冠脉介入治疗后心电图ST段回落不良与临床预后的关系研究  

ST-segment resolution in acute ST-elevation myocardial infarction after primary percutaneous coronary intervention: short / long-term prognosis and associated factors

作　　者：任雪丽[1] 谭仕芸 沈桂冬[2] 陈海波[1] 金鑫[1] 刘杰[1] 邓丽丽[1] 

机构地区：[1]安康市人民医院 [2]陕西省安康市中心医院,陕西安康725000

出　　处：《川北医学院学报》2015年第6期841-844,共4页Journal of North Sichuan Medical College

摘　　要：目的:研究急性心肌梗死(acute myocardial infarction,AMI)经皮腔内冠脉介入治疗(percutaneous coronary intervention,PCI)后心电图ST段回落(ST segment resolution,STR,STR)不良与患者临床近、远期预后关系。方法:选取发病12 h内于我院导管室行急诊PCI治疗的110例急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者的临床资料,根据术后1 h常规12导联心电图STR程度分为对照组(STR≥50%,n=59)和STR不良组(STR<50%,n=51),比较两组患者PCI术后住院期间不良心脏事件发生率以及术后1、6及12个月时左心房内径、左心室舒张末径、左心脏室射血分数、左心室短轴缩短率、E峰/A峰等心脏超声各项指标之间的差异。结果:STR不良组住院期间MACE发生率和住院时间明显高于对照组(P<0.05)。STR不良组术后1、6、12个月心脏功能明显低于对照组,心室重构明显高于对照组(P<0.05)。结论:ST段抬高型AMI患者经PCI术后,STR程度与临床近、远期预后密切相关,ST充分回落可作为预测病人近期、远期临床预后良好指标。Objective： To investigate the value of electrocardiogram ST segment（ STR） in the short and long-term prognosis of patients with acute myocardial infarction（ AMI） after percutaneous coronary intervention（ PCI）. Methods： Clinical data of 110 patients with acute ST segment elevation myocardial infarction underwent PCI treatment within 12 hours after onset was analyzed. According to the heartbeat figure STR were divided into group： control group（ STR≥50%,n = 59） and STR negative group（ STR 50%,n = 51）.Adverse cardiac events during hospitalization were observed in two groups after operation PCI（ MACE）. And postoperative left ventricular three-dimensional color Doppler ultrasound in 1,6,12 months of LA,LVEF,FS,E / A,LVEDd of the difference were also compared. Results： Compared with the control group,the duration of hospitalization and MACE were significantly higher in the STR negative group（ P〈0. 05）,and the functions of heart were significantly lower after 1,6,12 months（ P〈0. 05）. The left ventricular remodeling is significantly higher than that of the control group（ P〈0. 05）. Conclusion： According to our study,patients with AMI after PCI,the level of STR is closely related to clinical short-term and long-term clinical prognosis and can be used as a good indicator.

关 键 词：急性ST段抬高型心肌梗死 经皮腔内冠脉介入治疗 STR 临床预后 心脏功能 

分 类 号：R542.22[医药卫生—心血管疾病]