急性心肌梗死尿激酶静脉溶栓后ST段回降分析

Analysis of reduction in ST-segment elevation after intravenous thrombolysis with urokinase in patients with AMI

目的 探讨心电图早期估价急性心肌梗死 ( AMI)尿激酶静脉溶栓疗效及预测临床预后的快捷指标。方法 根据溶栓后心电图 ST段抬高之和 (Σ ST)的回降程度 ,将 46例 AMI患者分为 A组 (Σ ST回降≥ 5 0 % ,n=2 9)与 B组 (Σ ST回降 <5 0 % ,n=17)。对照分析两组患者的冠脉再通率、SPECT心肌节段评分、CK峰值、住院期间及随访心脏事件发生率。结果 与 B组相比 ,A组患者冠脉再通率高 ( P<0 .0 2 5 )、CK峰值低 ( P<0 .0 5 )、SPECT心肌节段评分低 ( P<0 .0 5 ) ,临床经过及预后好。结论 Σ ST段抬高恢复是一个适用于无束支传导阻滞及陈旧性心肌梗死患者的早期预测溶栓疗效及预后良好指标。

Objective To evaluate the significance of ECG prediction of early reperfusion after intravenous thrombolysis with urokinase AMI.Methods On basis of the reduction in ST segment elevation in all leads,46 cases with AMI were divided into two groups(group A:Σ ST≥50%,n=29;group B:Σ ST<50%,n=17).Contrasive analysis was performed about the patients' coronary reopening rate,SPECT myocardial segments scoring,peak level of CK and incidence of cardiac events during in hospital and follow up periods.Results In contrast with those in group B,in group A the coronary reopening rate was higher (P<0.025),peak level of CK was lower(P<0.05),score in SPECT myocardial segments was lower.In addition,patients of group A experienced a better clinical course and prognosis.Conclusion As a simple, inexpensive and noninvasive marker,Σ ST alterations after fibrinolysis (except the patients with bundle branch bloke or previous mayocardial infarction)can serve as a good indicator for assessment of the effectiveness of thrombolysis in patients with AMI.