急性心肌梗死静脉溶栓后早期T波倒置的临床意义

The Clinical Effect of Earlier T-wave Inversion after Phlebthrombolysis on the Patients with Acute Myocardial Infarction (AMI)

目的 :探讨溶栓后早期T波倒置的临床意义。方法 :将 6 1例急性心肌梗死 (AMI)接受溶栓治疗的患者分为 2 4h内T波倒置组和未倒置组。①依据临床间接血管再通标准观察两组再通情况 ;②比较两组血清肌酸磷酸激酶 (CK)酶峰出现时间和峰值。结果 :①两组血管再通率分别为 86 .49%和 1 2 .50 % (P <0 .0 1 )②两组CK酶酶峰出现时间分别为 ( 1 3.2± 3.5)h和 ( 1 9.5± 4.3)h(P<0 .0 1 ) ;两组CK酶峰值分别为 ( 1 2 6 5.8± 432 .3)IU L和 ( 1 846 .7± 52 6 .5)IU L(P <0 .0 1 ) ;③溶栓后早期T波倒置预示冠脉再通的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为 91 .43%、80 .77%、86 .89%、86 .49%和 87.50 %。结论 :早期T波倒置可作为冠脉再通的可靠诊断指标。

Objective: To evaluate the clinical effect of earlier T wave inversion after phlebthrombolysis. Method: 61 cases of acute myocardial infarction (AMI) receiving phlebthromblysis were divided into two groups: the one with T wave inversion within 24 hours and the other without any inversion. ①The patency rates of infarct related coronary artery of the two groups were assessed by uniform clinical criteria. ②The time and the peak value of serum CK enzyme peak between the two groups were compared. Results: ①The patency rates of the two groups were 86.49% and 12.50% respectively. ②The time of the Ck enzyme peak was (13.2±3.5) h and (19.5±4.3) h respectively .The peak value of the Ck enzyme peak was (1 265.8±432.3) lU/L and (1 846.7±526.5) lU/L respectively ( P <0.1); ③The patency of infarct related coronary artery of earlier T wave inversion after phlebthrombolysis showed susceptibility, specificity, degree of accuracy, positive value and negative value for prediction to be 91.43%, 80.77%, 86.89%, 86.49% and 87.50% respectively. Conclusion: Earlier T wave inversion after phlebthrombolysis is an effective criteria for patency of infarct related coronary artery.