心电图ST-T变化与急性心肌梗死患者急诊经皮冠状动脉介入术预后的关系  

The Relationship between Changes in Electrocardiogram ST-T and Prognosis of Emergency Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

作　　者：薛姗娜 吴岩 XUE Shanna;WU Yan(Department of Emergency,Xi'an Daxing Hospital,Xi'an Shaanxi 710016)

机构地区：[1]西安大兴医院急诊科,陕西西安710016 [2]宝鸡市中医医院心血管内科,陕西宝鸡721001

出　　处：《医学临床研究》2024年第2期214-217,共4页Journal of Clinical Research

摘　　要：【目的】探讨心电图ST-T变化与急性心肌梗死(AMI)患者急诊经皮冠状动脉介入术(PCI)预后的关系。【方法】对本院行急诊PCI治疗的244例AMI患者随访6个月,根据预后结局分为预后不良组和预后良好组,心电监护记录患者术前心电图ST-T抬高及术后1 h、24 h心电图ST-T回落程度。分析影响预后的危险因素。评估术前及术后心电图ST-T回落程度对PCI手术预后的预测价值。【结果】244例患者中预后不良28例,预后不良组发病至介入治疗时间、术后1个月左心室舒张末期内径(LVDd)水平均高于预后良好组(P<0.05);预后不良组术后1个月左室射血分数(LVEF)、术前至术后1 h及术前至术后24 h心电图ST-T段回落程度均低于预后良好组(P<0.05)。Logistic回归分析结果显示,发病至介入治疗时长延长、术后1个月LVDd水平升高、术后1个月LVEF水平降低、术前至术后1 h及24 h心电图ST-T段回落程度低均是AMI患者PCI术后预后不良的危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,心电图术前至术后1 h及24 h ST-T段回落程度对PCI术后预后不良预测的曲线下面积分别为0.721和0.718。【结论】心电图ST-T演变与AMI患者PCI术后预后的结局密切相关,且心电图ST-T回落程度可用于辅助预测患者的预后。【Objective】To investigate the relationship between the changes of ST-T segment in electrocardiogram and the prognosis of patients with acute myocardial infarction(AMI)undergoing emergency percutaneous coronary intervention(PCI).【Methods】A total of 244 patients with AMI who underwent PCI treatment in our hospital were followed up for 6 months.According to the prognosis,they were divided into a poor prognosis group and a good prognosis group,Electrocardiographic monitoring was used to record the ST-T elevation before surgery and the degree of ST-T drop at 1 hour and 24 hours after surgery.The risk factors affecting prognosis were analyzed.The predictive value of ST-T drop in electrocardiogram before and after surgery for the prognosis of PCI surgery was evaluated.【Results】Among the 244 patients,28 had a poor prognosis.The time from onset to intervention treatment and the level of left ventricular end-diastolic diameter(LVDd)at 1 month after surgery in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The levels of left ventricular ejection fraction(LVEF)at 1 month after surgery and the degree of ST-T drop from pre-to post-1 hour and pre-to post-24 hours were lower than those in the good prognosis group(P<0.05).Logistic regression analysis showed that prolonging the time from onset to intervention treatment,increasing the level of LVDd at 1 month after surgery,reducing the level of LVEF at 1 month after surgery,and reducing the degree of ST-T drop from pre-to post-1 hour and pre-to post-24 hours were all risk factors for a poor prognosis in patients with AMI undergoing PCI surgery(P<0.05).Analysis of receiver operating characteristic curve showed that the area under the curve of ST-T drop in electrocardiogram from pre-to post-1 hour and 24 hours in predicting a poor prognosis after PCI surgery was 0.721 and 0.718,respectively.【Conclusion】The evolution of ST-T segment in electrocardiogram is closely related to the prognosis of patients with AMI undergoing PCI surgery,

关 键 词：心肌梗死 急性病 血管成形术 气囊 冠状动脉 心电描记术 预后 

分 类 号：R542.22[医药卫生—心血管疾病]