【摘要】 目的探讨急性心肌梗死(AM I)行直接经皮冠状动脉腔内成形术(PTCA)+支架术后心电图早期ST段回落幅度与左心室结构、功能的关系。方法首次患AM I并接受直接PTCA的患者32例。比较PTCA术前和术后1 hST段抬高的高度,按ST段下移>50%及ST段下移<50%,分别分为A组(21例)和B组(11例)。所有患者于术后4周进行临床评估和二维彩色多普勒超声心动图检查。结果随访期间两组患者均未发生死亡,A组心功能Ⅲ~Ⅳ级2例,B组心功能Ⅲ~Ⅳ级5例(P<0.05)。4周后A组左心室射血分数(LVEF)、收缩末容积指数(LVESVI)、舒张末容积指数(LVEDVI)和全心室壁运动指数(GWMSI)均显著优于B组(P<0.05);梗死区室壁运动指数(RWMSI)在两组间无显著性差异。结论成功的直接PTCA后ST段的早期回落是反映心肌组织再灌注的简便可靠的指标,ST段回落>50%者的心脏功能、室壁运动及左心室重构情况明显优于ST段回落<50%者。更多还原

【Abstract】 AIM To study the relationship between the extent of early electrocardiographic ST-segments elevation resolution and the left ventricular(LV) constitution and function in acute myocardial infarction(AMI) after direct percutaneous transluminal coronary angioplasty(PTCA) and intracoronary-stent.METHODS Thirty-two patients with AMI successfully treated with direct PTCA were selected and the extent of the ST-segments elevation resolution on admission and one hour after direct PTCA were analyzed.The patients were divided into two groups: ST-segments elevation resolution﹥50%(group A) and ST-segments elevation resolution﹤50%(Group B).All the patients underwent clinical assessment and echocardiography four weeks after primary PTCA.RESULTS During follow-up period,no patients were dead.The number of patients with III-IV Killip degree was 2 in Group A and 5 in Group B(P<(0.05)).The differences of LV ejection fraction(LVEF),end-systolic volume index(ESVI),end-diastolic volume index(EDVI) and global wall motion score index(GWMSI) were statistically significant between group A and group B 4 weeks after infarction(P<0.05).There was no significant difference in regional wall motion score index(RWMSI).CONCLUSION ST-resolution after successful PTCA is a simple and effective marker of myocardial reperfusion and ST-segments elevation resolution >50% have better effect on LV function,global wall motion and LV remodeling.更多还原