STEMI患者心肌酶峰及心电图与左心室功能关系研究

Study on the relationship of the left ventricular function with myocardial enzyme peak and electrocardiogram in patients with STEMI

目的 :探讨ST段抬高型急性心肌梗死患者左心室功能与心肌酶峰、心电图的相关性。方法 :选择2013年2月~2015年11月到我院就诊的120例STEMI患者进行研究,经临床诊断后进行静脉药物溶栓或者经皮冠状动脉(PCI)治疗,分为早期和延迟再灌注两个组,比较两组患者的心电图、心肌酶峰、左心室功能指标。结果 :两组患者的性别、年龄、并发症及用药等均无统计学差异,但两组患者的左前降支病变血管、Killip分级及FMC有统计学差异;早期再灌注组的∑ST、∑R、∑Q、ST波、Q波、心肌酶峰指标、BNP最高值及LVEDD均显著高于延迟再灌注组,差异有统计学意义,而延迟再灌注组的LVEF略高,差异有统计学意义;早期再灌注组心电图梗死相关导联的∑ST、∑Q、ST波、Q波与Killip分级、心肌酶峰指标、BNP及LVEDD呈正相关,与LVEF呈负相关;∑R与心肌酶峰指标、BNP及LVEDD呈负相关,与LVEF呈正相关;ST段抬高幅度、Q波最大值与Killip分级、心肌酶峰指标、BNP及LVEDD呈正相关。其中BNP和LVEF与左心功能的相关性最大,差异均有统计学意义。结论 :STEMI患者心电图ST段抬高越多、Q波和心肌酶指标(CK、CK-MB、c Tn T)越高、R波越小,左心室功能越差,值的继续深入研究。

Objective To study the clinical curative effect of metformin combined with insulin aspart in patients with gestational diabetes mellitus. Methods From Feb 2014 to Nov 2015, 120 patients with STEMI were selected. After clinical diagnosis, all patients were treated with intravenous drug thrombolysis or percutaneous coronary artery(PCI) treatment, which were divided into early reperfusion group and delayed reperfusion group. ECG、myocardial enzyme peak index and left ventricular function index were compared in two groups. Results The basic clinical data of the two groups were not statistically significant, but the left anterior descending artery lesions, Killip classification and FMC were statistically different; Early reperfusion group of ∑ST、∑R、∑R, ST wave, Q wave, myocardial enzymes peaks and BNP highest value and LVEDD were significantly higher than those of delayed reperfusion group. The ∑ST, ∑Q, ST wave, Q wave and Killip class, myocardial enzymes peaks index, BNP, LVEDD was negatively correlated; ∑R and myocardial enzymes peaks index, BNP and LVEDD was negatively correlated, positively Among them, BNP and LVEF were more sensitive indexes of left ventricular function. Conclusion STEMI patients with higher ST segment elevation、Q wave and myocardial enzyme index(CK, CK-MB, c Tn T), the smaller the R wave, the left ventricular function is worse, it is worth further reaearch.