急性心肌梗塞心肌再灌注心电图定量研究

Quantitative ECG extimation after myocardial reperfusion in patients with acute myocardial infarction

本文对１７例接受尿激酶（溶栓组）、２５例接受极化液（非溶栓组）治疗的急性心肌梗塞患者运用心电定量心肌梗塞面积。用药前采用ＳＴ段运算法预计梗塞面积，住院７２ｈ后用ＱＲＳ积分法计算实际梗塞面积，二者之差为梗塞缩小面积，并以此计算梗塞心肌存活率，大于－２０％者为再灌注。结果显示溶栓组平均心肌梗塞面积缩小６．７％，梗塞区心肌存活率－２９．２％，早期溶栓（＜３ｈ）４例（４／５）符合心肌再灌注标准；晚期溶栓（３～８ｈ）６例（６／１２）符合再灌注标准。而非溶栓组无一例符合再灌注标准。故认为溶栓治疗是急性心肌梗塞的首选方法。

Quantitative ECG was used to estimate infarct size in 42 patients in CCU of ourhospital during recent 2 years.Among these patients,17 in the thrombolytic group were treatedwith urokinase,and 25 in the non-thrombolytic group with GIK. Before medication,ECGs weretaken to predict infarct size using ST segment algorithm method,and ECGs taken 72 hours afteronset of AMI was used to estimate the actual infarct size. The reduction in infarct size and my-ocardial salvage were calculated. Myocardial salvage>-20%was taken as reperfusion.The re-sults showed that the mean reduction of infarct size and myocardial salvage in the thrombolyticgroup were 6.7%and-29.2%respectively.On the contrary,in the non-thrombolytic group,infarct size was extended slightly(P<0. 001).In the thrombolytic group,both reduction in in-farct size and the reperfusion rate were more marked in patients treated earlier than in thosetreated later.