急性心肌梗死患者溶栓治疗后胸导QRS波群综合电压对预后的影响

Effect of voltage of QRS wave complex on prognosis in patients with AMI after thrombolytic therapy

目的通过对急性前壁、前间壁心肌梗死患者三次心电图QRS波群综合电压(R+S)的观察和比对,探讨急性心肌梗死患者溶栓治疗后胸导QRS波群综合电压对预后的影响。方法符合溶栓治疗的急性前壁ST段抬高型、前间壁ST段抬高型心肌梗死患者64例,分别测量患者入院后第1次心电图,尿激酶150万U静脉溶栓治疗后半小时至1小时期间心电图,患者出院前最后一次心电图。对前间壁、前壁有关导联中的三次心电图的QRS波群综合电压分别进行比对。结果梗死面相关导联中QRS波群综合电压(R+S)三次心电图相互比较差异均无统计学意义(P>0.05)。结论胸导QRS波群综合电压(R+S)的变化不能作为一项判断急性心肌梗死患者给予溶栓治疗后提高血管再通率、挽救濒死心肌、保护心功能、改善预后、预防心衰和降低患者死亡率的指标之一。

Objective To evaluate the effect of voltage of QRS wave complex on prognosis after thrombolytic therapy, observation and comparison of three electrocardiograms about the voltage （ R ＋ S） of QRS wave complex of patients with anterior or anteroseptal AMI were carried out. Methods Sixty four patients with anterior or anteroseptal AMI ST segment elevations were collected. Their electrocardiograms were taken at admission, 0.5 - 1 hour after thrombolytic therapy and the last day before pre-discharge. The voltage of QRS wave complex in anterior or anteroseptal leads of three electrocardiograms was analyzed. Results In infarction related leads, voltage of QRS wave complex differences in three electrocardiograms have no statistical significance（P 〉 0.05 ）. Conclusion Variations of voltage （ R ＋ S） of QRS wave complex in chest leads cannot indicate the effect of thrombolytic therapy, which may improve revas- cularization rate, save dying myocardium, protect cardiac function, improve the prognosis, prevent heart failure and reduce the death rate.