急性心肌梗死患者PCI术后ST段变化与其左室射血分数的关系  

Relationship Between ST Segment and Left Ventricular Ejection Fraction in Patients with Acute Myocardial Infarction After PCI

作　　者：李淼 朱笑寒 刘士超[3] LI Miaol;ZHU Xiaohan;LIU Shichao(Department of Cardiology,Shenqiu County People's Hospital,Zhoukou 466300;Department of Thoracic Surgery,Shenqiu County People's Hospital,Zhoukou 466300;Department of Cardiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]沈丘县人民医院心内科,河南周口466300 [2]沈丘县人民医院胸外科,河南周口466300 [3]郑州大学第二附属医院心内科,河南郑州450000

出　　处：《河南医学研究》2022年第11期1955-1958,共4页Henan Medical Research

基　　金：河南省科技攻关项目(LHGJ20210382)。

摘　　要：目的观察80例急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后ST段变化与其左室射血分数(LVEF)的关系。方法选取2018年3月至2021年9月沈丘县人民医院收治的80例AMI患者,均行PCI术及术后心电图(ECG)检查,根据术后1hST段变化分为对照组(ST段回落<50%,n=13)和观察组(ST段回落≥50%,n=67)。对比两组一般资料、不同时间纽约心脏病协会(NYHA)心功能分级情况及心功能相关指标[左心房径、LVEF、左室舒张末直径、左室舒张末期容积(LVEDV)]、围手术期相关情况及术后不良心血管事件发生率,分析AMI患者PCI术后ECG检查ST段回落与其LVEF水平的关系。结果两组性别、年龄、梗死部位、基础疾病、吸烟史及用药情况等对比,差异无统计学意义(P>0.05);术后3个月,观察组心功能分级优于对照组(P<0.05);术后3个月观察组左心房径、左室舒张末直径、LVEDV低于对照组,LVEF高于对照组(P<0.05);Pearson分析结果显示,AMI患者PCI术前、术后3个月ECG检查ST段回落与其LVEF水平均呈负相关关系(r_(1)=-0.632,r_(2)=-0.647,r_(3)=-0.710,P<0.05);观察组住院时间短于对照组,心绞痛、AMI复发、心律失常、Killip≥Ⅲ级等不良心血管事件发生率[11.94%(8/67)]低于对照组[61.54%(8/13)](P<0.05)。结论PCI术后ECG检查ST段回落≥50%AMI患者心功能恢复及预后较好,不良心血管事件发生率较低,临床监测ST段回落情况有利于评估患者病情程度及预后,需加强对预测预后较差患者的临床监护。Objective To observe the relationship between the changes of ST segment and left ventricular ejection fraction(LVEF)after percutaneous coronary intervention(PCI)in 80 patients with acute myocardial infarction(AMI).Methods A total of 80 patients with AMI admitted to Shenqiu County People’s Hospital from March 2018 to September 2021 were selected for PCI and postoperative electrocardiogramc(ECG)examinations,and they were divided into control group(ST segment fall<50%,n=13)and observation group(ST segment fall≥50%,n=67)according to the changes in ST segment 1 h after surgery.The general data of the two groups,New York Heart Association(NYHA)cardiac function classification and cardiac function-related indicators[left atrial diameter,LVEF,left ventricular end diastolic diameter,left ventricular end-diastolic volume(LVEDV)]at different times and perioperative related conditions and the incidence of postoperative adverse cardiovascular events were compared.The relationship between the ST segment fall in ECG examination and the LVEF level of AMI patients after PCI were analyzed.Results There was no statistical difference between the two groups in gender,age,infarct location,underlying disease,smoking history and drug use(P>0.05).Three months after operation,the cardiac function classification of the observation group was better than that of the control group(P<0.05).The left atrial diameter,left ventricular end-diastolic diameter and LVEDV of the observation group were lower than those of the control group,and the LVEF was higher than that of the control group(P<0.05).Pearson analysis showed that the ST segment fall of ECG examination before PCI and 3 months after operation was negatively correlated with the level of LVEF in patients with AMI(r_(1)=-0.632,r_(2)=-0.647,r_(3)=-0.710,P<0.05).The hospital stay of the observation group was shorter than that of the control group,and the incidence of adverse cardiovascular events such as angina,AMI recurrence,arrhythmia,Killip≥Ⅲgrade[11.94%(8/67)]was lower than that of

关 键 词：急性心肌梗死 左室射血分数 经皮冠状动脉介入术 心电图 

分 类 号：R542.22[医药卫生—心血管疾病]