急性心肌梗塞早期溶栓后心电图ST段改变与预后

Effect of ST segment change on clinical prognosis in patients with acute myocardial infarction after thrombolytic therapy

目的:探索急性心肌梗塞(AMI)早期溶栓治疗后,心电图抬高的ST段回降的幅度对临床预后的影响。方法: 描记88例AMI早期患者溶栓治疗后1 h、2 h、3 h、1 d、3 d等时段的心电图,根据有、无早期(溶栓后2 h)ST段的恢复分为三组:A组,ST段基本恢复至等电线,即回降的幅度≥90％;B组,ST段回降的幅度在50％～90％之间; C组,ST段回降的幅度不到50％。比较三组心肌酶、左心功能及住院病死率。结果:血清肌酸激酶(CK)峰值、左室射血分数(LVEF)及病死率,A组与B组、C组相比较有显著差异(P<0．05,或<0．01):A组CK峰值低、LVEF 高、预后好;C组则相反。结论:AMI早期溶栓后的心电图ST段变化,有助于对临床预后的评估。

Objective： To investigate the effect of ST segment change on clinical prognosis in patients with acute myocardial infarction （AMI） after thrombolytie therapy. Methods： The 88 AMI patients after thrombolytie therapy were divided into three group according to with or without rapid （2 h after thrombolysis） ST segmend descend： Group A： ST segment almost recoveries to base line;group B： ST segment elevation descended from 50 % to 90%; group C： ST segment elevation descended less than 50%. The CK levels, the left ventricle ejection fraction （LVEF） and the hospitalization cardiogenie mortality were compared with each other in the three groups. Results： The CK peak was lower and the LVEF was higher in group A, than those of group B, C （P〈0. 05, or 〈0.01）. The group C was worst in prognosis. Conclusion： The ECG monitor after thrombolytic therapy is helpful for evaluation of clinical prognosis.