急性心肌梗死溶栓治疗后ST段再抬高的临床分析

Clinical analysis of re-elevated ST segment after intravenous thrombolysis in acute myocardial infarction

目的 :观察急性心肌梗死 (AMI)静脉溶栓治疗后ST段再抬高的临床特点。方法 :回顾性分析符合静脉溶栓标准的AMI患者 1 0 7例 ,根据溶栓后有无ST段再抬高而分为ST段抬高组 (A组 )和ST段未抬高组 (B组 ) ,比较两组间发病年龄、伴发疾病、梗死相关血管、再通率、梗死后开始溶栓时间、再灌注心律失常、心功能变化 (Kil lip分级)。结果 :A组伴发糖尿病、高血压、高脂血症、梗死血管多支病变、心功能不全、再灌注心律失常发生率均高于B组 ,而冠状动脉再通率明显低于B组。结论 :溶栓治疗后ST段再抬高与患者并发糖尿病、高血压、高脂血症密切相关 ,梗死相关冠状动脉存在多支病变。该类患者再通率低 ,心肌受损重 ,易并发心功能不全 。

Objective:To observe the clinical features of re-elevated ST segment after intravenous thrombolysis in acute myocardial infarction(AMI) patients. Method: One hundred and seven AMI patients who received intravenous thrombolysis administration were divided into re-elevated ST segment group(group A) and non-re-elevated ST segment group(group B). Age of initial symptom, accompanied diseases, infarction related artery, the frequency of artery reopened, initial thrombolytic time, reperfusion arrhythmia and heart function grade were compared in these two groups. Result: No significants were founded in two groups in age, initial symptom, infarction related artery and initial thrombolytic time. There were more accompanied diabetes, hypertension, hyperlipidemia, two or more artery of infarction related artery, heart function disorder and reperfusion arrhythmia in group A than that in group B. However, the frequency of reopened coronary artery in group A was much less than that in group B. Conclusion: Re-elevated ST segment after intravenous thrombolysis is related with accompanied diabetes, hypertension, hyperlipidemia. These features result in lower reopen frequency of infarction related artery, severe injured myocardium, more tendency of heart failure and high frequency of reperfusion arrhythmia.