急性心肌梗死再通后心电图演变与心功能的关系

ST segment T wave changes on ECG 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术的患者72例,按术后1 h ST段是否回落≥50%和24 hT波是否倒置各分为两组。术后1 hST段回落≥50%组48例,<50%组24例,发病后24 hT波倒置组50例,未倒置组22例。随访6个月,分别于1个月和6个月时测量心功能。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 1个月时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)。6个月时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1 h内ST段早期回落和24 h T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 60 patients with AMI after successful primary PCI were studied. 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 but not in 18. All patients had a successful PCI and underwent 3Dechoeardiography and Doppler tissue imaging （DTI） soon after PCI atl and 6 months 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.