抬高的ST段恢复时间对预测溶栓治疗后室壁运动的临床意义

Clinical significance of recovery time of elevated ST segment in predicting infarct wall motion after thrombolytic therapy

目的 :探讨抬高的ST段恢复时间对预测溶栓治疗后室壁运动的临床意义。方法 :将冠心病监护病房收治并接受静脉尿激酶溶栓治疗且符合梗死相关血管再通标准的 180例AMI患者 ,根据溶栓后心电图抬高的ST段达到稳定下移 5 0 %的时间 ,分成A组 (时间在 30min内 ,n =4 6 )、B组 (6 0min内 ,n =6 3)及C组 (90min内 ,n =71) ,分别测定 3组的梗死血管室壁运动幅度。结果 :抬高的ST段达到稳定下移 5 0 %所需的时间不同 ,梗死相关室壁运动幅度存在差异〔急性前壁心肌梗死相关室间隔运动幅度A、B、C 3组分别为 (8.15± 1.6 2 )、(7.84± 1.4 3)及 (6 .5 6± 2 .15 )mm ,P <0 .0 5 ;急性下壁心肌梗死相关左室后壁运动幅度 3组分别为 (8.78±1.92 )、(7.32± 1.5 4 )及 (6 .15± 2 .0 5 )mm ,P <0 .0 5〕 ,且随需要的时间延长 ,梗死相关的室壁运动幅度有下降的趋势。结论 :抬高的ST段恢复时间越短 。

Objective:To observe the clinical significance of recovery time of elevated ST segment in predicting infarct wall motion after thrombolytic therapy.Method: One hundred and eighty cases of AMI were treated with intravenous urokinase thrombolytic therapy, and their infarct related arteries were reperfused. According to the recovery time of elevated ST segment achieved to stable 50% depression after thrombolytic therapy, 180 patients were divided into 3 groups; group A, 30 minutes, 48 cases; group B, 60 minutes, 63 cases; and group C, 90 minutes, 71 cases. In the meanwhile, the moving amplitude of the infarct related vessel walls of all patients was examined.Result: The moving amplitude of interventricular septum in acute anterior myocardial infarction in group A、B and C was ( 8.15 ± 1.62 ),( 7.84 ± 1.43 ) and ( 6.56 ± 2.15 ) mm respectively (P< 0.05 ); and in acute inferior myocardial infarction was ( 8.78 ± 1.92 ), ( 7.32 ± 1.54 ) and ( 6.15 ± 2.05 ) mm respectively (P< 0.05 ). It appeared that infarct related wall motion was decreased as time to achieve stable 50% ST segment recovery was prolonged.Conclusion: The shorter recovery time of elevated ST segment, the better improvement of the infarct related wall motion.