不同时间窗开通罪犯血管对急性心肌梗死患者心率减速力的影响  

Different time window opened the criminal blood vessels in patients with acute myocardial infarction on deceleration capacity of rate

作　　者：唐宇[1] 高明杰[2] 

机构地区：[1]首都医科大学附属北京潞河医院心内科,北京101149 [2]首都医科大学宣武医院血管超声诊断科,北京101149

出　　处：《临床和实验医学杂志》2017年第8期774-776,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探究不同时间窗开通罪犯血管对急性心肌梗死(AMI)患者心率减速力(DC)的影响。方法选择2015年2月至2016年2月期间收治106例首次发生急性ST段抬高型AMI患者,均于发病12 h内成功进行急诊经皮冠状动脉介入术(PCI)治疗,根据通罪犯血管开通时间分为超早期组49例(<6 h)和早期组57例(6~12 h),所有研究对象均予动态心电图记录仪记录24 h心电图数据,观察对比两组DC变化,并评估两组梗死后危险分层,分析不同开通时机与梗死后高危风险的关系。结果超早期组DC值为(5.81±0.43 ms)明显高于对照组(4.05±0.56 ms),差异有显著性(P<0.05)。超早期组高危风险率(4.08%)明显低于早期组(17.54%),差异有显著性(P<0.05)。Cox比例风险回归模型分析发病至梗死相关动脉(IRA)开通时间>6 h可增加梗死后高危风险(RR=2.269,95%CI:1.128~4.851,P=0.026)。结论超早期(<6 h)开通罪犯血管可有效提高AMI患者DC值,梗死后高DC值对降低梗死后风险等级及改善临床预后质量有重要的临床价值。Objective To explore the influence of different time window opened the criminal blood vessels in patients with acute myocar-dial infarction （AMI） on deceleration capacity of rate. Methods From February 2015 to February 2016 , 106 cases of acute ST segment elevation AMI patients were included into the present study. All patients received successfully PCI treatment within 12h after disease attacking. According to the criminal vascular time window opening time, these patients were divided into super early group, including 49 cases （ 〈 6 h） and the early group, including 57 cases （6-12 h）.All the research subjects received the dynamic ECG recorder of 24 h ECG data. The dynamic ECG data of the two groups were compared and analyzed the relationship between opening time and high risk after infarction. Results The DC value of early group was （5.81 ±0.43） ms, which was significantly higher than that of control group （4？ 05 ±0？ 56） ms （ P 〈0.05）. The DC value of super early with high risk rate was 4. 08% , which was significantly lower than the 17. 54% of the early group （ P 〈 0. 0 5） . Cox proportional hazards re-gression model analysis demonstrated that the IRA opening time 〉 6 h can increase the risk of infarction with high risk （RR = 2. 269, 95 % CI： 1.128 - 4. 851, P =0.026）. Conclusion The early （ 〈6 h） opening the criminal blood vessels can effectively improve the DC value of AMI patients. High DC values can reduce the risk of infarction after infarction and improve the quality of clinical prognosis.

关 键 词：急性心肌梗死 血管开通时间窗 心率减速力 

分 类 号：R542.22[医药卫生—心血管疾病]