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Title:: Clinical value of resolution of early STsegment elevation after primary PTCA in acute myocardial infarction

作者:: 杨文奇; 毛淑丹; 陶贵周; 锦州医学院附属第一医院心血管病诊治中心，辽宁锦州 121001

Author(s):: YANG Wen-qi; MAO Shu-dan; TAO Gui-zhou; Department of Cardiology, First Affiliated Hospital，Jinzhou Medical College, Jinzhou，Liaoning 121001, China

关键词:: 心肌梗塞; 经皮冠状动脉成形术; ST段; 心室重构

Keywords:: myocardial infartion; percutaneous transluminal coronary angioplasty; ST segment; ventricular remodeling

分类号:: R541.4

DOI:: -

文献标识码:: A

摘要:: 目的探讨急性心肌梗死(AMI)行直接经皮冠状动脉腔内成形术(PTCA)+支架术后心电图早期ST段回落幅度与左心室结构、功能的关系。方法首次患AMI并接受直接PTCA的患者32例。比较PTCA术前和术后1 h ST段抬高的高度，按ST段下移>50%及ST段下移<50%,分别分为A组(21例)和B组(11例)。所有患者于术后4周进行临床评估和二维彩色多普勒超声心动图检查。结果随访期间两组患者均未发生死亡, A组心功能Ⅲ~Ⅳ级2例，B组心功能Ⅲ~Ⅳ级5例（P<0.05）。4周后A组左心室射血分数(LVEF)、收缩末容积指数(LVESVI)、舒张末容积指数(LVEDVI)和全心室壁运动指数(GWMSI)均显著优于B组（P<0.05）；梗死区室壁运动指数(RWMSI)在两组间无显著性差异。结论成功的直接PTCA后ST段的早期回落是反映心肌组织再灌注的简便可靠的指标，ST段回落>50%者的心脏功能、室壁运动及左心室重构情况明显优于ST段回落<50%者。

Abstract:: AIM To study the relationship between the extent of early electrocardiographic STsegments elevation resolution and the left ventricular(LV) constitution and function in acute myocardial infarction (AMI) after direct percutaneous transluminal coronary angioplasty (PTCA) and intracoronarystent. METHODS Thirty-two patients with AMI successfully treated with direct PTCA were selected and the extent of the ST-segments elevation resolution on admission and one hour after direct PTCA were analyzed. The patients were divided into two groups: STsegments elevation resolution﹥50% (group A) and ST-segments elevation resolution﹤50% (Group B). All the patients underwent clinical assessment and echocardiography four weeks after primary PTCA. RESULTS During followup period, no patients were dead. The number of patients with IIIIV Killip degree was 2 in Group A and 5 in Group B (P<0.05). The differences of LV ejection fraction (LVEF), endsystolic volume index (ESVI), enddiastolic volume index (EDVI) and global wall motion score index (GWMSI) were statistically significant between group A and group B 4 weeks after infarction (P<0.05). There was no significant difference in regional wall motion score index (RWMSI). CONCLUSION ST-resolution after successful PTCA is a simple and effective marker of myocardial reperfusion and STsegments elevation resolution >50% have better effect on LV function, global wall motion and LV remodeling.

参考文献/References

［1］陈小林,查道刚,张稳柱,等. 急性心肌梗死再灌注治疗后早期ST段变化预测心肌微血管功能［J］. 中国循环杂志,2002,17(3):177-179.

［2］ Sheiban I, Fragasso G,Rosano GM, et al. Time course and determintants of left ventricular function recovery after primary angioplasty in patients with acute myocardial infarction［J］. J Am Coll Cardiol,2001,38(2):464-471.

［3］ MartinezElbal L,RuizNodar JM,Zueco J,et al.Direct coronary stenting versus stenting with balloon predilation :immediate and followup results of a multicentre,prospective,randomized study［J］ . Eur Heart J， 2002,23(8):633-640.

［4］ TomaszukKazberuk A,Musial WJ,Dobrzycki S,et al. Normalisation of elevated ST segment predicts return of left ventricular systolic function and improved outcome in patients with acute myocardial infarction, treated with primary coronary angioplasty［J］. Kardiol Pol, 2004, 60(6):541-549.

［5］ Matetzky S,Freimark D,Chouraqui P,et al. The distinction between coronary and myocardial reperfusion after thrombolytic therapy by clinical markers of reperfusion［J］. J Am Coll Cardiol, 1998，32(5):1326-1330.

［6］ Bainey KR,Senaratne MP. Is the outcomes of early STsegment resolution after thrombolytic therapy in acute myocardial infarction always favorable?［J］. J Electrocardiol,2005，38(4):354-360.

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急性心肌梗死直接PTCA后早期ST段改变及其临床意义(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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