急性心肌梗死心肌组织再灌注的心电图ST段动态变化分析  

Clinical analysis of early diagnosis of myocardial reperfusion in patients with acute myocardial infarction by dynamic changes of electrocardiogram ST segment

作　　者：李淑岩[1] 崔丽杰[1] 王丽杰[1] 那君 姜仲卓[1] 解小萌 宋亮[1] 赵含章[1] 

机构地区：[1]辽宁省人民医院心脏中心,沈阳110016

出　　处：《陕西医学杂志》2017年第1期51-52,共2页Shaanxi Medical Journal

基　　金：辽宁省沈阳市科技项目(130620)

摘　　要：目的:探讨术前、术后即刻心电图表现与急性心肌梗死(AMI)心肌组织再灌注相关性。方法:对244例急性心肌梗死患者进行术前常规生化指标检测,分别在术前、术后即刻、术后12h,进行18导联心电图检测。结果:无复流者ST段抬高总和高于正常者(P<0.05);无复流者C型ST段抬高、再灌注心律失常均高于正常者(P<0.05);再灌注心律失常发生率、再灌注心律失常者发病时间、ST段抬高导联数目低于无再灌注心律失常者(P<0.05);术后24hCK-MB、cTnT水平低于术前(P<0.05);术后即刻、术前ST段抬高导联数目(r=0.542、r=487,P<0.05)、抬高总和下降幅度(r=0.563、0.539,P<0.05),与CK-MB、cTnT术后24h水平较术前下降幅度呈正相关;A组、B组、C组、D组无复流率与再灌注心律失常发生率差异有统计学意义(P<0.05)。结论:AMI再灌注与术前心电图有关,术后即刻心电图较术前是否改善,可作为再灌注心律失常预测指标。Objective ：Analysis of the correlation between the acute infarction （AMI） and the myocardial tissue reperfusion in patients with acute myocardial infarction （yocardial） before and after the operation .Methods ：From patients with acute myocardial infarction admitted to hospital emergency department as the research object , Selected objects in 244 cases ,Preoperative biochemical indexes were detected in the patients ,before and after operation ,12h ,18 lead ECG detection .Results ：The sum of ST segment elevation was higher than normal ,C type ST segment elevation ,reperfusion arrhythmia ,Higher than normal ,the difference was statistically significant （P〈 0 . 05） ;Reperfusion arrhythmia incidence ,The time of onset of reperfusion arrhythmia and the number of ST segment elevation lead were lower than those without reperfusion arrhythmia ,and the surprise was statistically significant （P〈 0 .05） ;24hCK‐MB and cTnT levels were lower than preoperative ,and the difference was statistically significant （P〈 0 .05） ;The number of ST segment elevation lead ,and the sum of elevation were higher than that before operation ,The level of 24h was positively correlated with the decrease of level after cTnT and CK ‐MB ;A group ,B group ,C group ,D group ,there was no significant difference in the incidence rate of reperfusion arrhythmia （P〈 0 . 05） .Conclusion ：AMI reperfusion was related to preoperative ECG ,There was an improvement in the performance of the ECG immediately after operation ,which can be used as the prediction index of reperfusion arrhythmias .

关 键 词：心肌梗塞/诊断 再灌注损伤/诊断 心电描记术  便携式 

分 类 号：R542.22[医药卫生—心血管疾病]