急性心肌梗死患者术后ST段变化与左室射血分数的相关性  

Correlation Between Postoperative ST Segment Changes and Left Ventricular Ejection Fraction in Patients with Acute Myocardial Infarction

作　　者：罗玉荣[1] 杜泽华[1] 武甲龙 LUO Yurong;DU Zehua;WU Jialong(Department of Cardiovascular Medicine,Sanmenxia Central Hospital,Sanmenxia 472000,China)

机构地区：[1]三门峡市中心医院心血管内科,河南三门峡472000

出　　处：《河南医学研究》2022年第16期2964-2967,共4页Henan Medical Research

摘　　要：目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后ST段变化与左室射血分数(LVEF)的关系。方法选取三门峡市中心医院2019年8月至2020年8月就诊的112例AMI患者,均接受PCI术治疗,术后1 h行心电图(ECG)检查,根据ST段回落(STR)程度分为两组(回落不良组28例,回落良好组84例)。比较两组术前、术后1周心功能指标[左室舒张末期容积(LVEDV)、LVEF、E/A]、血清心肌损伤标志物[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)]、脑钠钛(BNP)水平及术后1个月主要不良心血管事件(MACE)发生情况,分析心功能、血清心肌损伤标志物、BNP水平与STR相关性。结果与回落不良组相比,术后1周回落良好组LVEF、E/A较高,血清CK-MB、cTnⅠ、BNP水平较低(P<0.05);经Pearson相关性分析可知,STR与LVEF、E/A呈正相关(r=0.677,P<0.05),与血清CK-MB、cTnⅠ、BNP呈负相关(r=-0.724,P<0.05);与回落不良组MACE总发生率相比,回落良好组较低(P<0.05)。结论AMI患者PCI术后ST段变化与LVEF、心肌损伤标志物、BNP水平具有相关性,临床可通过STR评估术后心功能及预测预后,从而给予相应术后治疗措施。Objective To investigate the relationship between ST segment changes and left ventricular ejection fraction(LVEF)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 112 patients with AMI who visited Sanmenxia Central Hospital from August 2019 to August 2020 were selected and treated with PCI,and electrocardiogram(ECG)was performed 1 h after the procedure.Patients were divided into two groups(28 cases in the group with poor regression and 84 cases in the group with good regression)according to the group degree of ST-segment regression(STR).The preoperative and 1-week postoperative cardiac function indexes[left ventricular end-diastolic volume(LVEDV),LVEF,E/A],serum myocardial injury markers[creatine kinase MB(CK-MB),cardiovascular troponinⅠ(cTnⅠ)],brain natriuretic peptide(BNP)levels and the occurrence of major adverse cardiovascular events(MACE)at 1 month after surgery were compared between the two groups,and the correlation between cardiac function,serum myocardial injury markers,BNP levels and STR was analyzed.Results Higher LVEF and E/A and lower serum CK-MB,cTnⅠand BNP levels in the group with good regression at 1 week postoperatively compared with the group with poor regression(P<0.05).As shown by Pearson correlation analysis,STR was positively correlated with LVEF and E/A(r=0.677,P<0.05)and negatively correlated with serum CK-MB,cTnⅠand BNP(r=-0.735,r=-0.724,r=-0.695,P<0.05).The total incidence of MACE in the group with good regression was lower than that in the group with poor regression(P<0.05).Conclusion ST segment changes after PCI in AMI patients correlate with LVEF,myocardial injury markers and BNP levels,and clinical assessment of postoperative cardiac function and prediction of prognosis by STR can be used to give appropriate postoperative therapeutic measures.

关 键 词：急性心肌梗死 心电图 心功能 心肌损伤标志物 主要不良心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病]