影响急性心肌梗死急诊PCI后心电图ST段恢复的相关因素分析

The factors related to resolution of elevated ST-segment in the patients with acute myocardial infarction having been treated by primary percutaneous coronary intervention

目的分析影响急性心肌梗死急诊经皮冠状动脉介入治疗(PCI)后心电图ST段恢复的相关因素。方法患者行急诊PCI术后1 h和术前患者的18导联心电图(ECG),测量并比较急诊PCI前后梗死相关导联最大ST段抬高幅度。按抬高的ST段下降幅度分为:A组,ST段下降≥50%;B组,ST段下降<50%。分析患者相关临床资料与ST段下降之间的关系。结果2组患者性别、年龄未见明显差异;在糖尿病、梗死前心绞痛、梗死部位、Killips心功能分级、Q波计数、发病至急诊时间方面有显著差异;而在急诊至球囊开通时间以及梗死血管直径方面无显著差异。结论急性心肌梗死经急诊PCI术后心电图ST段恢复程度与糖尿病、梗死前心绞痛、梗死部位、Killips心功能分级、Q波计数、发病至急诊时间等有关,它们可能是影响ST段恢复的因素。

Objective To analyze the factors related to ST- segment resolution in patients with acute myocardial infarction （AMI） after primary percutaneous coronary intervention （PCI）. Methods The 18 - lead ECG before PCI and 1 h after PCI were reviewed. According to the resolution of the ST- segment elevation in the infarct - related lead, the patients were classified into two groups; group A , with ST- segment resolution ≥50% ; group B, with ST- segment resolution 〈 50% .The factors associated with ST- segment resolution were identified. Results The differences between the 2 groups were not related to sex or age, the time from arriving at emergency room to the start of PCI, or the diameter of the infarct - related artery. ST- segment resolution was found to be related to diabetes mellitus history, angina pectoris before MI, infarct area, Killip class of heart function, number of Q waves, and the time from symptom onset to arrival at emergency room. Conclusion The factors that affect ST- segment resolution should be seriously concerned and actively managed in performing PCI to secure a favorable outcome of the AMI.