【摘要】 目的　探讨急性心肌梗死 (AMI)病人梗死相关动脉 (IRA)再通对晚电位 (VLP)的动态影响。方法　AMI患者 3 8例 ,于溶栓开始前佩戴数字化Holter记录仪进行 2 4h的长程晚电位连续监测 ,然后将病人分设两个亚组 :溶栓成功组与溶栓不成功组 ,比较这两组病人在溶栓前后VLP各项参数的变化情况 ,找出其与冠脉再通情况之间的关系。结果　AMI患者在溶栓前和溶栓后 3 0min内 ,VLP各项参数无明显统计学差异 ,而溶栓 2～ 3h后 ,再灌注组VLP各参数的数值明显变化 ,而无再灌注组则无这种变化。结论　再灌注在迅速恢复心肌缺血的情况下 ,于溶栓后早期可显著降低VLP的发生率 ,这不仅为临床提供了又一种新的评价冠脉再通的无创检测方法 ,且纠正了传统认为的VLP只有在心肌纤维瘢痕的基础上才能形成的认识更多还原

【Abstract】 Objectives This study aimed at finding cut if reperfusion could be identified by long term VLP,using digital Holter ECG.Methods 24 hour 3 channel digital Holter recorders were performed on 38 patients with AMI before thrombolytic therapy,then the patients were divided into successful reperfusion group and unsuccessful reperfusion group.Every parameter was comparied between the two groups.Results VLP parameters showed a gradual improvement in the acute phase of MI in patients with successful reperfusion compared with those of unsuccessful reperfusion and that a significant difference between these two groups became evident from 2～3 hour after thrombolysis.Conclusions Our investigation certifies that successful reperfusion reduces VLP positive rate significantly 2～3 hours after thrombolysis.Thus,long term ventricular late potential may be helpful for identification of the reperfusion in AMI patients.In the mean time,Our study is performed before the formation of myocardial fibrous scar in AMI patients,it breaks up the traditional concept that VLP only developed from the formation of myocardial fibrous scar.更多还原