ST段抬高型急性心肌梗死溶栓后心电图改变的临床意义

The clinical significance of electrocardiogram changes after thrombolysis in the patients with acute ST segment elevation myocardial infarction

目的通过分析急性心肌梗死抬高的ST段下降幅度,评价溶栓治疗过程中ST段改变对患者心功能的预测价值。方法96例ST段抬高型急性心肌梗死患者,入院后行溶栓治疗,并计算溶栓后2h内ST段抬高振幅总和(ΣSTE)的下降幅度。结果溶栓治疗2h后,ΣSTE较溶栓治疗前下降大于50%时,病人自觉胸痛症状消失,心功能得到较好保护。而ΣSTE较治疗前下降小于50%时,患者心功能不同程度受损。结论ST段抬高型急性心肌梗死的患者经早期溶栓治疗后,其抬高的ST段下降幅度可作为心肌血供能否恢复的间接预测指标,从而能较准确地反映心肌再灌注情况及预测心功能状态。

Objective To evaluate the predictive value of ST segment changes to heart function in the pa- tients with acute ST segment elevation myocardial infarction（STEMI）. Methods 96 patients with STEMI were underwent thrombolysis therapy and the summary of ST segment decline were calculated after thrombolysis. Results In the patients whose ST segment decline were more than 50% compared with pretherapy, the symptoms disappeared and the function were reserved and the patients whose ST segment decline were less than 50% compared with pretherapy,the heart function decreased. Conclusions The decline degree of ST segment can be used as a indirect index to evaluate myocardial refusion and predict the heart function.