急性心肌梗死患者行经皮冠状动脉介入治疗后ST段改变的
意义
李军丽
【期刊名称】《新乡医学院学报》 【年(卷),期】2012(029)008
【摘要】目的 探讨急性心肌梗死患者行经皮冠状动脉介入(PCI)术后早期ST段回落的临床意义.方法 选取接受急诊PCI治疗的急性心肌梗死患者32例,根据PCI术后ST段的改变分为ST-T改变组(21例)和无ST-T改变组(11例),同时将ST-T改变组根据发病至PCI治疗时间分为≤6 h组(12例)和>6h组(9例),分析比较PCI术后1、6、12 h的动态心电图变化特征.PCI术后1、6个月行超声心动图检查,检测左心室射血分数(LVEF)及左心室舒张末期内径(LVDd).观察≤6 h组与>6h组ST段回落指数的变化,ST-T改变组与无ST-T改变组的心功能改善情况及远期心血管事件发生情况.结果 PCI治疗后,≤6 h组及>6h组ST段回落指数均>50%,且术后1、6、12 h的回落指数组间比较差异有统计学意义(P<0.01).随访期间ST-T改变组LVEF显著高于无ST-T改变组,LVDd低于无ST-T改变组,差异有统计学意义(P<0.05).ST-T改变组心血管事件发生率明显低于无ST-T改变组(P<0.01,P<0.05).结论 通过观察PCI术后ST-T的动态改变,可了解PCI术后心功能的改善情况,对心血管事件发生的预测有重要的临床意义.%Objective To explore the prognostic significance of early ST segment descent after percataneous coronary artery intervention (PCI) in acute myocardial infarction ( AMI) patients. Methods Thirty-two cases with AMI who treated with PCI were divided into ST segment change
group ( n = 21) and non ST segment change group ( n = 11 ). And the ST segment change group was divided into two subgroup according to the time from attack to the operation of PCI; =?6 hours group(n = 12) and >6 hours group(n = 9). The changes of dynamic electrocardiogram were analyzed in 1 hour,6 hours and 12 hours after PCI. Echocardiography was used to detected the left ventricular ejection fraction (LVEF) and left ventricular end diastolic dimension (LVDd) one month and six months after PCI. The changes of ST-segment descent index in ≤6 hours group and >6 hours group were observed, and the improvement of heart function and long-dated cadiovascular events in ST segment change group and non ST segment change group were observed too. Results After PCI,the descending index of ST segment was more than 50% in ≤6 hours group and >6 hours group;and the descending index of ST segment in 1 hour,6 hours and 12 hours after PCI had significant difference between the two groups(P <0. 01). Compared with non ST segment change group,in ST segment change group,the LVEF was higher,LVDd was lower(P <0.05). The incidence of cadiovascular events in ST segment change group was lower than non ST segment change group (P<0.01,P<0. 05). Conclusion The improvement of heart function after PCI can be estimated by the dynamic changes of ST-T, and it is significant clinical significance in pretesting the cadiovascular events.
【总页数】3页(625-627)
【关键词】急性心肌梗死;经皮冠状动脉介入;ST段回落指数 【作者】李军丽
【作者单位】驻马店市中心医院心电功能科,河南 驻马店 463000 【正文语种】中文 【中图分类】R542.2+2 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_journal-xinxiang-medical-university_thesis/0201246499952.html 【相关文献】
1.急性ST段抬高心肌梗死患者经皮冠状动脉介入治疗后ST段回落不良的相关因素及短期预后 [J], 寿晔; 蒋跃绒
2.静脉溶栓治疗后经皮冠状动脉介入治疗与直接经皮冠状动脉介入治疗对老年急性ST段抬高型心肌梗死患者的临床效果观察 [C], 戚彩艳; 张玉卫
3.高敏C反应蛋白联合全球急性冠状动脉事件注册风险评分对ST段抬高型急性心肌梗死患者经皮冠状动脉介入治疗后远期主要不良心血管事件预测价值 [J], 杨欣苗; 金泽宁; 李红; 蒲连美; 陈辉; 王凡
4.老年急性ST段抬高心肌梗死合并心源性休克患者主动脉内球囊反搏辅助下经皮冠状动脉介入治疗的护理体会 [J], 周莲; 江敏; 文玲; 朱建芳; 黄雪娇; 陈尹; 杨晓
5.比较溶栓结合经皮冠状动脉介入治疗与直接经皮冠状动脉介入治疗对前壁急性ST段抬高型心肌梗死患者冠状动脉微循环的影响 [J], 李向明; 傅向华