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Title:: Relation between elevation level of ST segment and early outcomes after primary percutaneous coronary intervention for acute myocardial infarction

作者:: 邓捷¹; 韩雅玲²; 臧红云²; 梁明²; 1. 第四军医大学西京医院心内科, 陕西西安 710032; 2. 沈阳军区总医院全军心血管病研究所心内科, 辽宁沈阳110016

Author(s):: DENG Jie¹; HAN Ya-ling²; ZANG Hong-yun²; LIANG Ming²; 1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi′an，Shaanxi 710032, China, 2.Department of Cardiology, General Hospital, Shenyang Military Area Command, Shenyang,Liaoning 110016, China

关键词:: 心肌梗塞; 急性; 心电图; 预后

Keywords:: myocardial infarction; acute; electrocardiogram; prognosis

分类号:: R542.22

DOI:: -

文献标识码:: A

摘要:: 目的探讨急诊冠状动脉介入术(PCI)后ST段恢复程度对急性心肌梗死(AMI)患者早期预后的影响。方法452例AMI患者根据其术后ST抬高程度分为3组: ST抬高<1.0 mm组(210例)，ST抬高1.0~2.0 mm组(178例)以及ST段抬高>2.0 mm组(64例)，分析3组患者住院期间再次发生AMI、恶性心律失常、泵衰竭和死亡的情况。结果随着ST段抬高幅度增加,3组患者的泵衰竭发生率分别为6.7%、12.9%和17.2%(P<0.05),恶性心律失常发生率分别为2.9%、5.1% 和12.5%(P<0.05)，院内病死率分别为1.4%、3.9% 和9.4%( P<0.05)及急性心肌再梗死率分别为0%、2.2%和 4.7% (P<0.05)。分析显示术后单导联ST段抬高幅度是院内不良事件发生的最强独立预测因素［OR=2.42, 95%CI：(1.17~4.02), P<0.01］。结论单导联ST段抬高幅度是划分急诊PCI术后早期预后危险分层的一种简单有效的方法。

Abstract:: AIM To analyze the early prognostic impact of STsegment resolution in acute myocardial infarction following the percutaneous coronary intervention (PCI). METHODS According to the STsegment elevation in the single ECG lead of following PCI, a total of 452 consecutive patients were divided into three groups: <1.0 mm group ( n=210), 1.0 to 2.0 mm group ( n=178) and >2.0 mm group ( n=64). Clinical outcomes were evaluated. RESULTS The frequency of the inhospital adverse outcomes increased in the three groups: pump failure (6.7% vs. 12.9% vs. 17.2%, P<0.05), malignant arrhythmia (2.9% vs. 5.1% vs. 12.5%, P<0.05), inhospital mortality (1.4% vs. 3.9% vs. 9.4%, P<0.05) and reinfarction (0% vs. 2.2% vs. 4.7%, P<0.05). The single ECG lead of elevation was found to be the strongest independent predictor of inhospital adverse outcomes, (hazard ratio 2.42, 95% confidence interval 1.17 to 4.02, P<0.01). CONCLUSION The single ECG lead of STsegment elevation is a simple method to stratify patients by risk after primary PCI for acute myocardial infarction.

参考文献/References

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［2］中华心血管病杂志编委会. 急性心肌梗死溶栓疗法参考方案［J］. 中华心血管病杂志,1996,24 (5) :328-329.

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［4］杨丽霞, 齐峰, 王先梅,等. 经皮冠状动脉介入治疗对心肌梗死患者心功能的影响［J］. 心脏杂志, 2004, 16 (4)：329-331.

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［8］ Prasad A, Stone GW, Aymong E, et al Impact of STsegment resolution after primary angioplasty on outcomes after myocardial infarction in elderly patients: an analysis from the CADILLAC trial［J］. Am Heart J, 2004,147(4):669-675.

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急诊PCI术后ST段抬高幅度与早期预后的关系(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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