冠状动脉介入治疗后心电图T波振幅的变化

Change of amplitude of T wave after percutaneous coronary intervention

目的观察经皮腔内冠状动脉介入治疗(PCI)后T波振幅的变化规律。方法38例有一支或多支冠状动脉狭窄达75%以上并行经皮冠状动脉介入治疗的冠心病患者。术前、术后1d、3d、1周、1个月同步描记12导联体表心电图。测量T波振幅并计算12导联总正向T波振幅(ΣT+)和12导联总负向T波振幅(ΣT‐)。根据经皮冠状动脉介入治疗后有无明显负向T波倒置加深分为明显T波深倒组(SDNT)和非明显T波深倒组(NSDNT)。结果明显T波深倒组10例(26.3%),术后1d、3dΣT+明显减小,随后逐渐增大;ΣT‐在经皮冠状动脉介入治疗后1d负值增大,随后逐渐减小,1个月时达最小;非明显T波深倒组28例(73.7%),ΣT+、ΣT‐术前至术后1周变化不大,ΣT+术后1个月明显增大,ΣT‐术后1个月负值减小。结论经皮冠状动脉介入治疗后一过性T波倒置加深为术后常见T波变化。经皮冠状动脉介入治疗后1周～1月T波振幅渐进性改善,正向T波振幅增大,负向T波振幅减小。

Objective To investigate the change tendency of amplitude of T-wave after percutaneous coronary intervention （PCI）. Methods 38 patients with coronary heart disease was divided into two groups （significant deeper negative T-wave group, SDNT group;no significant deeper negative T-wave group, NSDNT group） according to with or without significant deeper negative T-wave after PCI. All selected patients were examined by coronary angiocardiography and done PCI for the stenosis lesions above 75 percent . At baseline and 1,3,7 days and 1 month after PCI,synchronous 12 lead electrocardiography were recorded. To measure amplitude of T-wave and compute sigma positive T-wave （∑T＋） and sigma negative T-wave （∑T - ）. Results In SDNT group, The sigma amplitude of positive T-wave decreased 1 , 3 days after PCI, then began to increase; The sigma amplitude of negative T-wave increased 1 day after PCI than baseline, then began to decrease. In NSDNT group, There wasn＇t significant difference among the time points from baseline to 1 week after PCI for the sigma positive T- wave and sigma negative T-wave, however, the sigma amplitude of sigma positive T-wave increased significantly 1 month after PCI, the sigma amplitude of negative T-wave decreased 1 month after PCI. Conclusions Temporarily deeper negative T-wave might be a frequently seen phenomenon in a week after PCI. From one week to one month after PCI. T-wave improved gradually： the amplitude of positive T-wave increased and the amplitude of negative T-wave decreased.