急性心肌梗死冠状动脉再通后ST段回落缓慢的意义

The significance of elevated ST segment slow reduction after coronary artery recanalization in patients with acute myocardial infarction

５４例急性心肌梗死（ＡＭＩ）患者溶栓或经皮冠状动脉腔内成形术（ＰＴＣＡ）后梗死相关冠状动脉（ＩＲＡ）再通，９０分钟时ＳＴ段上移总和回落＜５０％为甲组（３５例），≥５０％为乙组（１９例）。与乙组比较，甲组溶栓距发病时间及肌酸激酶（ＣＫ）峰值距发病时间延长。住院期间心脏事件发生率甲组（３８％）显著高于乙组（１０５％，Ｐ＜００５），而且出院前超声心动图检查显示，甲组收缩末期容量较乙组增大，射血分数减低。因此ＡＭＩ患者ＩＲＡ再通后ＳＴ段回落缓慢提示心功能不良及预后欠佳。

Among 54 patients with acute myocardial infarction (AMI) who had patent infarct releted coronary artery (IRA) after successful thrombolytic therapy or rescue angioplasty.35 casess (group 1) experienced and 19 cases did not have a reduction in the sum of ST segment elevation by<50% at 90min.The time from onset of syndrome to thrombolytic therapy and peak CK was longer in group 1 than in group 2.Cardiac event rate was higher in group 1 (38%) than in group 2 (10.5%,[WT5BX]P<0 05).Predischarge echocardiograghic study showed the group 1 patients had larger left ventricular end systolic volume and lower ejection fraction than those in group 2.Thus,after AMI patients with slow reduction of ST segment elevation had poor left ventricular function and prognosis despite patent IRA.