急性冠脉综合征介入术后心电图变化与生存质量的相关性

Correlation Study of Electrocardiogram Changes and Life Quality After the Intervention Therapy of Acute Coronary Syndrome

目的:探究急性冠脉综合征(ACS)介入术后心电图变化与生存质量的相关性。方法:研究对象为某院2016年12月~2017年12月收治的80例ACS介入术后的患者,于术前及术后1h、24h记录心电图,按术后1h ST段回落是否≥50%和24h T波是否倒置各分为4组,术后1h ST段回落≥50%的有19例,<50%的有22例,术后24h T波倒置的有24例,未倒置的有15例。探讨介入治疗后心电图ST段和T波演变与预后的关系。结果:ST段回落≥50%组1个月、6个月时在左室射血分数(LVEF)上与ST段回落<50%组相比显著较高(P<0.05);而T波倒置组1个月、6个月时在LVEF上与T波未倒置组相比显著较高(P<0.05);4组在1个月时的左心室舒张末期内径(LVD)上无显著差异(P>0.05),而在6个月时ST段回落≥50%组显著比ST段回落<50%组低(P<0.05),T波倒置组显著比T波未倒置组低(P<0.05);在术后1个月及6个月SF-36评分上,ST段回落≥50%组显著比ST段回落<50%组高(P<0.05),T波倒置组显著比T波未倒置组高(P<0.05)。结论:心电图演变是反映心脏血管的指标,临床可根据ACS介入术后心电图变化来判断患者心功能情况,PCI术后ST段早期回落及T波倒置的患者预后较好,生存质量高,该方法值得应用与推广。

Objective: To explore the correlation of electrocardiogram(ECG) changes and life quality after the intervention therapy of acute coronary syndrome(ACS). Methods: 80 ACS patients undergoing the intervention therapy in a hospital from December 2016 to December 2017 were selected. The ECG was recorded before surgery, after 1 h and 24 h of surgery. According to ST segment resolution(<50% or ≥50%) after 1 h of surgery and 24 h T wave inversion, patients were assigned to four groups, including 19 cases with ST segment resolution ≥50%, 22 cases with ST segment <50%, 24 cases with 24 T wave inversion after surgery and 15 cases without 24 T wave inversion. After the intervention therapy, the correlation of ST segment and T wave changes with patient’s prognosis was discussed. Results: After 1 m and 6 m of therapy, the left ventricular ejection fraction(LVEF) in patients with ST segment resolution ≥50% was significantly higher than patients with ST segment resolution <50%(P<0.05);After 1 m and 6 m of therapy, the LVEF in patients with T wave inversion was significantly higher than patients without T wave inversion(P<0.05);After 1 m of therapy, the left ventricular end-diastolic dimension(LVD) for four groups was not significantly different(P>0.05);After 6 m of therapy, the LVD in patients with ST segment resolution ≥50% was significantly lower than patients with ST segment resolution <50%(P<0.05);The LVD in patients with T wave inversion was lower than patients without T wave inversion(P<0.05);After 1 m and 6 m of therapy, the SF-36(the MOS item short from health survey) scores in patients with ST segment resolution ≥50% were significantly higher than patients with ST segment resolution <50%(P<0.05);The SF-36 scores in patients with T wave inversion were higher than patients without T wave inversion(P<0.05). Conclusion: The cardiovascular indicators can be reflected by the ECG changes. After the PCI(percutaneous coronary intervention), the ECG can be used to evaluate the patient’s cardiac function. Patients who have the early ST segment resolution and T wave inversion will promote the better prognosis and higher life quality. It is worthy of clinical application and promotion.