急性心肌梗死患者心电图ST段回落时间与预后的关系分析

The relationship between ST segment resolution time and acute prognosis in patients with acute myocardial infarction

目的分析急性心肌梗死(AMI)患者心电图ST段回落时间与预后的关系。方法选取2017年3月至8月在浙江大学医学院附属第一医院嵊州分院诊断且符合纳入标准的AMI患者65例为研究对象,依据心电图ST段回落时间分为A组(ST段回落50%的时间<40 s,47例)和B组(ST段回落50%的时间≥40 s,18例),所有患者均行经皮冠状动脉介入(PCI)治疗和99m锝-甲氧基异丁基异腈(99mTC-MIBI)心肌灌注断层显像,比较两组患者的左心室射血分数(LVEF)、心肌灌注断层显像情况及不良事件发生情况。结果AMI 1周后,A组患者的LVEF高于B组(P<0.05);静息时,两组患者的放射性缺损面积像素和缺损区域放射性计数百分比差异均无统计学意义(均P>0.05),硝酸甘油介入后,A组患者的放射性缺损面积像素低于静息时和B组(均P<0.05),缺损区域放射性计数百分比高于静息时和B组(均P<0.05);A组患者的充血性心力衰竭发生率低于B组(P<0.05)。结论心电图ST段回落时间较短的AMI患者预后情况较好。

Objective To analyze the relationship between ST segment resolution time and acute prognosis in patients with acute myocardial infarction(AMI).Methods A total of 65 patients with AMI were enrolled from Shengzhou People's Hospital during March 2017 to August 2017 andwere divided into groupA(ST segment resolution 50%time<40 s,n=47)and group B(ST segment resolution 50%time≥40 s,n=18).All patients underwent percutaneous coronary intervention and 99^mTC-methoxyisobutylisonitrile(^99mTC-MIBI)myocardial perfusion tomography.The left ventricular ejection fraction(LVEF),myocardial perfusion imaging and adverse events were compared between the two groups.Results LVEF was significantly higher in group A than in group B(P<0.05).The radioactive defect area and radiation count rate were not significantly different between the two groups at rest(all P>0.05).The radiation defect area was significantly smaller and radiation count rate was significantly higher in group A than in group B following sublingual glyceryl trinitrate(all P<0.05).The incidence of congestive heart failure was significantly lower in group A than in group B(P<0.05).Conclusion AMI patients with early ST segment resolution have a better prognosis in acute period.