急性心肌梗死溶栓治疗后非梗死相关导联ST段压低的临床意义

Clinical significance of ST-segment depression in non-infarct-related electrocardiographic leads after thrombolytic therapy for acute myocardial infarction

目的 探讨急性心肌梗死患者溶栓治疗后,非梗死相关导联ST段压低的临床意义。方法 将初发AMI住院并接受溶栓治疗冠状动脉再通的110名患者分为三组:持续性ST段压低组(1组)26例,一过性ST段压低组(2组)48例,无ST段压低组(3组)36例,随访30个月,观察3个组患者的存活率、心血管事件发生率及心功能与非梗死相关导联ST段压低的关系。结果 AMI溶栓治疗后,非梗死相关导联持续性ST段压低组的长期存活率(73%)显著低于2组(91.6%)和3组(91.7%)(P<0.05);而心律失常和心力衰竭(NYHA)发生率显著高于2组和3组(P<0.05)。结论 统计学分析表明非梗死相关导联持续性ST段压低是AMI溶栓治疗后长期存活率下降的独立危险因素。

Objective To investigate the clinical significance of ST-segment depression in non-infarct-related leads in patients who received thrombolytic therapy after acute myocardial infarction (AMI). Methods We evaluated 110 consecutive patients who were admitted with their first AMI and underwent thrombolysis. Patients were fol-lowedup for an average of 30 months and were classified into 3 groups: persistent ST-segment depresion(group 1), transient ST-segment depression (group 2)and absent ST-segment depression (group 3).The relation of long-term survival rate, cardiovascular event rates, heart function and non-infarct-related leads in three groups were observed. Results Long-term survival rates (73%) of patients who underwent thrombolysis with persistent ST-segment depression were signifieantly lower than those of group 2 (91. 6%) and group 3 (91. 7%) (P<0. 05). However, incidence of arrhythmia and heart failure in group 1 were higher than those of group 2 and group 3(P<0. 05). Conclusion Statistical analysis showed that the persistent ST-segment depression in non-infact-related leads after thrombolytic therapy for AMI were an independent risk factor for a decline in long-term survival.