经皮冠状动脉腔内成形术中冠状动脉内心电图的应用研究

Usage of intracoronary ECG during the procedure of PTCA

目的 探讨冠状动脉内心电图（ＩＣ－ＥＣＧ）在经皮冠状动脉腔内成形术（ＰＴＣＡ）术中的应用。方法对４４例冠心病病人的５１支冠状动脉行ＰＴＣＡ时记录ＩＣ－ＥＣＧ和体表ＥＣＧ，分析心绞痛组、心肌梗塞溶栓再通组、溶栓未通组ＩＣ－ＥＣＧ的缺血性心电图改变情况，并与体表监护导联ＥＣＧ相比较。结果９６．１％的血管行球囊扩张时ＩＣ－ＥＣＧ有缺血性改变；心绞痛组、心肌梗塞溶栓再通组及溶栓未通组的ＩＣ－ＥＣＧ的ＳＴ段上移程度有明显差别。结论ＩＣ－ＥＣＧ比体表ＥＣＧ在反映心肌缺血方面更敏感，ＰＴ－ＣＡ时ＩＣ－ＥＣＧ的ＳＴ段变化能一定程度地反映残余心肌的成活情况。

Objective To determine the usage of intracoronary ECG (IC-ECG) in the procedure ofpercutaneous transluminal angioplasty. Methods 44 patients with 51 vessel IC-ECG during PTCA procedure were recorded. Three group of patients were compared, angina group, AMI with successfulreperfusion and AMI with reperfusion failed. Results 96.1% vessels had significant ischemia on ICECG during balloon inflation. ST segment elevation on IC-ECG had significant difference among threegroups. Conclusion IC-ECG can be more sensitive than surface ECG in reflecting cardiac ischemia. Insome extent, ST segment elevation on IC-ECG during balloon inflation can reflect the amount of viablecardiac muscle.