急性冠脉综合征介入术后心电图的变化情况与患者生活质量的关系研究

Study on the relationship between the changes of electrocardiogram and quality of life in patients after interventional treatment of acute coronary syndrome

目的 探讨急性冠脉综合征（ACS）经皮冠状动脉介入术（PCI）后心电图的变化情况与患者生活质量的关系。方法 选择2011年11月-2014年11月于杭州市中医院行PCI术的ACS患者124例为研究对象,根据术后1h ST段是否回落超过50%以及24h T波是否倒置将其分为两组。其中术后1h ST段回落≥50%的患者（1h ST段回落≥50%组）80例,1h ST段回落〈50%患者（1h ST段回落〈50%组）44例;24h T波倒置患者（T波倒置组）85例,未倒置患者（T波未倒置组）39例。采用健康状况调查问卷（SF-36量表）对四组患者术后3个月生活质量进行评价,以探讨ACS患者PCI术后心电图的变化情况与其生活质量的关系;检测四组患者术后3个月的心功能。结果 11h ST段回落≥50%组SF-36量表各维度（生理功能、心理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康、躯体相关生活质量、心理相关生活质量及总得分）评分均显著高于1h ST段回落〈50%组（P〈0.05）,T波倒置组上述维度评分均显著高于T波未倒置组（P〈0.05）;2术后3个月,1h ST段回落≥50%组左心室射血分数（LVEF）、Em/Am、左室舒张末内径（LVED）均显著高于1h ST段回落〈50%组（P〈0.05）,T波倒置组上述指标水平均显著高于T波未倒置组（P〈0.05）;1h ST段回落≥50%组左心室舒张末期内径（LVDD）显著高于1h ST段回落〈50%组（P〈0.05）,T波倒置组上述指标均显著高于T波未倒置组（P〈0.05）。结论 ACS患者PCI术后心电图1h ST段回落≥50%及24h T波倒置是反映患者生活质量及心功能的重要指标,从而为ACS患者临床治疗效果的评价提供一定的参考依据。

Objective To investigate the acute coronary syndrome（ACS） and the relationship between changes of quality of life in patients with ECG after PCI. Methods 124 cases of PCI intervention in ACS patients in Traditional Chinese Medical Hospital of Hangzhou City from November 2011 to November 2014 were selected as the research objects,and they were divided into two groups according to the postoperative 1h ST down more than 50% and the 24 h T wave inversion respectively. 80 patients of postoperative 1h ST segment elevation ≥ 50% was 1h ST segment elevation ≥50% group, and 44 cases patients of postoperative 1h ST segment elevation 50% was 1h ST segment elevation 50% group; 85 patients of 24 h inverted T wave was T wave inversion group, and 39 patients with T wave non-inversion was T wave non-inversion group. The quality of life postoperative 3 months of patients in the four groups was evaluated by the SF-36 scale, the relation between the changes of the electrocardiogram and life quality of patients with ACS after PCI was discussed; and the cardiac function of 3 months with postoperative of patients in the four groups was determined. Results According to the SF-36 scale, each dimension（physiological function, psychological function, body pain, general health, vitality, social function, emotional function, mental health, physical health-related quality of life,psychological quality of life score and total score） of 1h ST segment elevation ≥ 50% group were significantly higher than that of 1h ST segment 〈50% group（P〈0.05）, the scores of T wave inversion group were significantly higher than that of T wave non-inversion group（P〈0.05）;LVEF, Em/Am, LVED of the 1h ST segment elevation≥ 50% group after 3 months were significantly higher than that of the 1h ST segment 〈50% group（P〈0.05）, above indexes of T wave inversion group were significantly higher than T wave non-inversion group（P〈0.05）; LVDD of the1h ST segment elevation ≥ 50% group was significantly higher than that in the 1h ST segment 〈50% group（P〈0.05）, Above indexes of T wave inversion group were significantly higher than T wave non-inversion group（P〈0.05）.Conclusion The ACS after PCI in patients with ST segment ECG 1h ≥ 50% and 24 h T wave inversion are important indexs to reflect the quality of life and heart function, so as to provide some reference for the evaluation of the clinical curative effect of the patients with ACS.