【摘要】 目的 评价急性心肌梗死患者急诊经皮冠状动脉介入(PCI)术后ST段回落幅度(STR)对近期预后的影响。方法 选择2012年1月至2015年6月在首都医科大学大兴医院住院的急性心肌梗死患者245例为研究对象,回顾性分析患者急诊PCI术后心电图单导联ST段回落幅度。将患者分为STR组和STR不良组,收集患者临床资料,比较两组患者住院期间心功能和主要不良心脏事件的差异。结果 STR组患者148例,STR不良组患者97例,STR不良发生率为39.6%。PCI术后TIMI血流达到3级而STR小于50%,的患者占32.5%。STR不良组患者住院期间B型利钠肽峰值为(415.9±168.3)pg/ml,左室舒张末期内径(54.7±15.3)mm,左室射血分数(49.2±5.9)%,与STR组比较差异有统计学意义(P<0.05)。97例STR不良组患者中发生主要不良心脏事件(MAC:E)的患者共24例,其中恶性心律失常8例、心力衰竭11例、心源性死亡4例,均高于STR组,差异有统计学意义(P<0.05)。结论急性心肌梗死患者急诊PCI术后仍有相当比例的患者发生ST段回落不良,这些患者具有较高的住院期间MACE发生率。更多还原

【Abstract】 Objective To evaluate the effect of ST segment resolution(STR) on prognosis in patients with acute myocardial infarction after emergency percutaneous coronary intervention.Methods 245 patients who were hospitalized in Beijing Daxing District People’s Hospital from January 2012 to June 2015 with acute myocardial infarction were selected for the study.The single-lead ECG ST-segment resolution amplitude after emergency PCI was retrospectively analyzed.The patients were divided into STR group and STR bad group.The clinical data were collected.The cardiac function and major adverse cardiac events during hospitalization were compared between two groups.Results STR group of 148 patients,STR poor patients 97 cases,the incidence of bad STR was 39.6%.Post-PCI TIM1 flow 3 grades and STR less than 50%of patients accounted for 32.5%.STR bad group during hospitalization B-type natriuretic peptide peak at(415.9±168.3)pg/ml,left ventricular end-diastolic diameter(54.7±15.3)mm,left ventricular ejection fraction of(49.2±5.9)%,there was significant difference compared with the STR group(P<0.05).Patients with major adverse cardiac events(MACE) occurred 97 cases of adverse STR patients in total 24 cases,8 cases of malignant arrhythmia,11 cases of heart failure and 4 cases of cardiac death,the ratios were higher than the STR group,the differences were statistically significant(P<0.05).Conclusion Acute myocardial infarction after emergency PCI is still a significant proportion of patients with ST segment poor resolution,these patients have a higher incidence of MACE during hospitalization.更多还原