急性冠脉介入与静脉溶栓对急性心肌梗死患者P波离散度的影响

Effect of Acute Percutaneous Coronary Intervention and Intravenous Thrombolysis on P-wave Dispersion in Patients with Acute Myocardial Infarction

【目的】通过急性冠脉介入(PCI)和静脉溶栓对急性心肌梗死(AMI)患者P波离散度(Pd)影响的对比研究,探讨两种治疗方法开通梗死相关冠状动脉(IRA)后对Pd的影响。【方法】将AMI患者随机分为两组:即急性PCI组和静脉溶栓组。观察急性PCI组和静脉溶栓开通IRA前及IRA开通后24 h内Pd变化,并对两种方法引起Pd变化进行对比分析。【结果】急性PCI成功组Pd由术前(44.6±10.4)ms减小为术后(28.9±11.7)ms(P<0.05),静脉溶栓成功组Pd由溶栓前(45.3±9.8)ms减小为溶栓后(35.6±10.9)ms(P<0.05)。【结论】急性PCI和静脉溶栓开通IRA均能降低AMI患者Pd,且急性PCI较静脉溶栓更能有效减小Pd,提示Pd可作为评价再灌注程度的临床指标。

[Objective]To compare the effect of acute percutaneous coronary intervention （PCI） and intravenous thrombolysis on P-wave dispersion （Pd） in patients with acute myocardial infarction （AMI）. [Methods]Patients with AMI were randomly divided into acute PCI group and intravenous thrombolysis group. Changes of Pd were observed and compared in two groups before infarct related artery （IRA） reperfused and after IRA reperfused within 24 hours. [Results]With IRA reperfused, Pd decreased from （44.6±10.4）ms be- fore acute PCI to （28.9±11.7）ms after acute PCI in acute PCI group（ P〈0. 05）, and Pd decreased from （45.3±9.8）ms before intravenous thrombolysis to （35.6±10.9）ms after intravenous thrombolysis in intravenous thrombolysis group（ P〈0.05）. [Conclusion]Pd could be decreased in patients with AMI whose IRA is reperfused hy either acute PCI or intravenous thromholysis, and acute PCI could decrease Pd more effectively than intravenous thrombolysis, that suggests Pd might be as a clinical reference for evaluating extent of IRA reperfused.