急性心肌梗死直接PCI后心电图演变与心功能的关系

The Relationship between ECG Changes and Left Ventricular Functional Improvement after PCI in Patients with Acute Myocardial Infarction.

目的:探讨ST段抬高型急性心肌梗死急诊介入治疗(PCI)后心电图ST段和T波演变与左心功能的关系。方法:选择初发ST段抬高型急性心肌梗死并行急诊PCI术的病人60例,按术后1hST段是否回落≥50%和24hT波是否倒置各分为两组。术后1hST段回落≥50%组40例,<50%组20例,发病后24hT波倒置组42例,未倒置组18例。随访180天,分别于第30天和第180天时测量心功能。用三维彩色多普勒技术测量左室射血分数(LVEF)和左室舒末内径(LVD),用多普勒心肌组织显像技术(DTI)测量并计算Em/Am。比较左心功能恢复情况。结果:30天时ST段早期回落组和T波早期倒置组LVEF、Em/Am值分别高于ST段未回落组和T波未倒置组(P<0.05),而LVD无明显差异(P>0.05)。180天时ST段早期回落组和T波早期倒置组LVEF、Em/Am值均高于ST段未回落组和T波未倒置组(P<0.05),ST段早期回落组和T波早期倒置组LVD值小于ST段未回落组和T波未倒置组(P<0.05)。结论:急诊PCI术后1h内ST段早期回落和24hT波早期倒置是反映左心功能恢复良好的指标。

Objective： To investigate the relationship between ST segment, T wave and Left Ventricular functional after PCI in patients with acute myocardial infarction. Methods： 60patients with AMI after successful primary PCI were studled. Following PCI, ST segment elevation ≥ 50% from baseline was documented in 40 patients but not in 20. After AMI 24 hours, only T wave inversions were documented in 42 hut not in 18. All patients had a successful PCI and underwent 3Dechocardiography and Doppler tissue imaging （DTI） soon after PCI at 30 days and 180 days later. Results： There are significant different in LVEF, Era/Am at 1 month and 6 month after PCI （P 〈0.05） in two groups. There are significant different in LVD at six moths after PCI （ P 〈 0. 05 ） But not in one moths （ P 〉 0. 05 ） . Conclusion： ST segment recovery and T wave early inversion on ECG can assess recovery of left ventricular dysfunctional.