急性心肌梗死溶栓治疗后早期T波倒置的临床意义

Clinical significance of the early T-wave inversion after thrombolytic therapy in acute myocardial infarction

目的 研究急性心肌梗死患者经静脉溶栓治疗后 2 4小时内梗死区心电导联T波变化的临床意义。方法 选择 10 7例确诊为急性心肌梗死 (AMI)患者 ,在发病 <6小时内接受重组链激酶 (思凯通 )溶栓治疗 ,根据溶栓后 2 4小时内T波倒置 ,分为T波倒置和T波未倒置组 ,并且记录两组的CK -MB、心电图ST段的变化及再灌注心律失常的发生率 ,观察T波倒置与其的关系。结果 溶栓治疗后 2 4小时内梗死区心电导联T波倒置组与T波未倒置组相比血清CK -MB峰值出现时间明显提前 (P <0 .0 1) ,峰值显著下降 (P <0 .0 5 ) ,且大多数伴随着ST段迅速回降 (P <0 .0 1) ,再灌注心律失常的例数增加 (P <0 .0 1) ,T波倒置的冠脉再通率显著高于T波未倒置组 (P<0 .0 1)。

Objective To study the meaning of T-wave inversion during the 24 hours after thrombolytic therapy in acute myocardial infarction.Methods 107 patients diagnosed with acute myocardial infarction were received thrombolytic therapy within 6 hours of onset. The patients were divided into T-wave inversion group and non-T-wave inversion group .The changements of creatine kinase(CK) and ST segment, and incidence of reperfusion arrhythmia were compared according to the relationship with T-wave inversion.Results The peak level of CK-MB in T-wave inversion group came earlier than that in non-T-wave inversion group. The degree of decreasing of the peak level of CK-MB with quick reduction of ST segment elevation(P<0.01)was lower in T-wave inversion group than that in non-T-wave inversion (P<0.05).Cases of reperfusion arrhythmia in T-wave inversion group were more than that in non-T-wave inversion group(P<0.01).The reperfusion rate of T-wave inversion group was significantly higher than that of non-T-wave inversion group.Conclusion The early T-wave inversion after thrombolytic therapy in acute myocardial infarction could be used as clinical make of reperfusion.