急性心肌梗死早期ST段预测梗死面积的意义

Clinical Significance of Predicting Final Myocardial Infarct Size from Initial ST-segment Deviation in AMI

目的 :探讨急性心肌梗死 (AMI)早期ST段与最终梗死面积之间的关系及溶栓治疗在其中的作用。方法 :分析 84例急性心肌梗死患者 (其中溶栓组n =31,对照组n =5 3)入院时和入院后 1周的 12 -导联体表心电图 ,用Aldrich公式预测梗死面积和SelvesterQRS积分系统计算最终梗死面积。结果 :溶栓组的最终梗死面积比早期预测梗死面积明显减小 (P <0 .0 5 ) ,其中有 15例 (48.39% )减少≥ 2 0 % ;而对照组的最终梗死面积与早期预测面积无明显差异 ,只有 7例 (13.2 1% )减少≥ 2 0 %。结论 :体表心电图抬高的ST段可用于早期预测梗死面积 ,作为评估溶栓治疗效果的一项无创、简便的方法。

Objective: To evaluate the relationship between initial ST-segment deviation and finial myocardial infarct size in AMI. Methods: Final myocardial infarct size which was estimated from the Selvester QRS scoring system was predicted from the admission standard ECG by the Aldrich's formula in 84 patients with first AMI undergoing ( n =31)or not undergoing ( n =53) thrombolysis. Results: There was a significant decrease from initial ST-predicting infarct size to final QRS-estimated infarct size in the thrombolytic group( P <0.05). 15(48.39%) of 31 thrombolytic patients had a ≥20% decrease from the predicted to final infarct size in the group and 7 (13.21%) of 53 control patients. Conclusion: ECG may be useful in predicting final AMI infarct size from ST-segment deviation ,providing a simple and noninvasive technique to evaluate the effect of intravenous thrombolytic therapy.