早期T波倒置判断冠脉再通的价值

Diagnostic value and prognosis for patency of infarct-related coronary artery by earlier T wave inversion after thrombolysis

目的探讨溶栓后早期T波倒置对闭塞冠状动脉再通的诊断价值及预后。方法选择78例急性心肌梗死(AMI)接受溶栓治疗的患者,分为24h内T波倒置组和未倒置组,依据临床间接血管再通标准观察两组再通情况。结果早期T波倒置组与未倒置组比较,前者较后者:①血管再通率高(p<0.01);②心肌酶酶峰明显提前,峰值显著下降(p<0.05);③心电图ST段迅速回降(p<0.01);④再灌注心律失常的发生率高(p<0.01);⑤心脏事件发生率低(p<0.05);⑥半年后左室LVEF改善明显(p<0.05)。结论早期T波倒置可作为冠脉再通的无创性可靠指标有助于检出高危患者。

Objective To evaluate the diagnostic value and prognosis for patency of infarct-related coronary artery by earlier T wave inversion after thrombolysis.Methods Seventy-eight cases receiving thrombolysis were divided into two groups： the one with T wave inversion within 24 hours and the other without that within 24 hours,the patency rate of infarct-related coronary artery were assessed by uniform clinical criteria.Results earlier T wave inversion was compared with or without T wave inversion： ①The patency rate of coronary artery is higher（p0.01）;②Peak of CK-MB and cTnI were evidently advanced date and data of peak evidently reduce（p 0.05）;③Level of ST segment rapidly cut down in ECG（p0.01）;④The arrhythmia of patency take place with higher frequency（p0.01）;⑤Cardiovascular events take place with lower frequency（p0.05）;⑥The LVEF was evidently improved after half year（p0.05）.Conclusions Earlier T wave inversion after thrombolysis is a non-invasive effective criteria for patency of infarct-related coronary artery and risk predicters.