急性心梗介入治疗后心电图演变与预后的关系

The Relationship between ECG and Left Ventricular Functional Improvement after PCI in Patients with Acute Myocardial Infarction

目的探讨ST段抬高型急性前壁心肌梗死急诊介入治疗(PCI)后心电图ST段和T波演变与预后的关系。方法选择初发ST段抬高型急性前壁心肌梗死并行急诊PCI术的病人80例,按术后1 h ST段是否回落≥50%和24 h T波是否倒置各分为两组。术后1 h ST段回落≥50%组55例,<50%组25例,发病后24 h T波倒置组53例,未倒置组27例。随访1年,分别于6个月和1年时测量心功能,用三维彩色多普勒技术测量左室射血分数(LVEF)和左室舒末内径(LVD),用多普勒心肌组织显像技术(DTI)测量并计算Em/Am。比较左心功能恢复情况。结果 6个月时ST段早期回落组和T波早期倒置组LVEF、Em/Am值分别高于ST段未回落组和T波未倒置组(P<0.05),而LVD无明显差异(P>0.05)。1年时ST段早期回落组和T波早期倒置组LVEF、Em/Am值均高于ST段未回落组和T波未倒置组(P<0.05),ST段早期回落组和T波早期倒置组LVD值小于ST段未回落组和T波未倒置组(P<0.05)。结论急诊PCI术后1 h内ST段早期回落和24 h T波早期倒置是反映左心功能恢复良好的指标。

Objective To investigate the relationship between ST segment , T wave and Left Ventricular functional after PCI in patients with acute anterior myocardial infarction.Methods 80 patients with AMI after successful primary PCI were studied.Following PCI, ST segment elevation ≥50% from baseline was documented in 55 patients but not in 25.After AMI 24 hours, only T wave inversions were documented in 53but not in 27.All patients had a successful PCI and underwent 3Dechocardiography and Doppler tissue imaging (DTI) soon after PCI at 6months and 1year later.Results There are significant different in LVEF, Em/Am at 6 months and 1year after PCI (P<0.05) in two groups.There are significant different in LVD at 1year after PCI (P<0.05) But not in 6 months (P>0.05).Conclusion ST segment recovery and T wave early inversion on ECG can assess recovery of left ventricular dysfunctional.