急性心肌梗死PTCA支架术后平板运动试验的动态变化

Dynamic Changes of Exercise Treadmill Test After the Emergent PTCA in Patients with Acute Myocardial Infarction

[目的]观察急性心肌梗死(AMI)急诊PTCA支架术后,平板心电图的动态变化.[方法]选择AMI患者36例(A组:24例,为AMI发病6h内来本院求治;B组:12例,为AMI发病6～12 h内求治).急诊行PTCA+支架植入术,在术后第1个月和6个月行平板心电图检查.[结果]36例患者第二次运动时间较第一次显著延长,其中A组(血运在6h内恢复重建)的患者,这种现象更为明显.两次试验运动前QT离散度无明显变化.第二次试验运动后即刻QT离散度较第一次试验运动后即刻的QT离散度显著降低. [结论]AMI急诊行PTCA支架术的患者,如果无严重并发症,术后一个月在严密的监护下,能够安全的进行平板运动试验.冠脉血运的尽早重建能使患者运动耐量增加更为明显.平板运动后即刻心肌QT离散度的恢复需要数个月以上的时间.

ObjectiveTo observe the changes of exercise treadmill test after emergent percutaneous transluminal coronary angioplasty(PTCA) in patients with acute myocardial infarction.Thirty six patients with acute myocardial infarction were given PTCA in six hours(group A ,24 patients) or six to twelve hours(group B,12 patients). ALL patients were given exercise treadmill tests one and six months later. The time of the second exercise treadmill test was significantly longer than that of the first, especially in group A.Before two tests, no significant differences were obsevered in QTc dispersion(QTcd). While compared with the first tests, the significant decrease of Qtcd was observed shortly after the second tests. [Conclusion] The patients with myocardial infarction are able to endure the exercise treadmill test one month after PTCA. The early complete rebuilding of blood circulation in the coronary vessels can significantly increase the patients' exercise endurance. However, the restoration of QTcd needs several months.