李美红,牛杰,冯新恒,郭丽君,张福春,王贵松,郭静萱,高炜

• 1:北京大学第三医院心内科
• 2:北京大学深圳医院心血管内科

摘要(Abstract)：

目的探讨急性ST段抬高心肌梗死(STEMI)直接经皮冠脉介入(PCI)后心电图残余ST段抬高总和与预后的关系。方法依据PCI后心电图残余ST段抬高总和(sumSTE)的程度将患者分为A组(sumSTE<0.1mV)、B组(0.1mV≤sumSTE<0.3mV)、C组(0.3mV≤sumSTE<0.7mV)和D组(≥0.7mV),观察sumSTE与住院期间左室射血分数(LVEF)及6月内总的主要心血管事件(MACE,包括心绞痛、再发心肌梗死、因心血管事件再入院、心衰和死亡等)发生率的关系。结果共有225例患者。男性156例,女性69例,年龄(61.3±12.7)岁。急性前壁梗死118例,非前壁心肌梗死107例。A组LVEF明显高于C组(57.68±6.72%比54.33±8.50%)和D组(57.68±6.72%比51.27±9.20%)。B组LVEF高于C组(57.60±8.40%比54.33±8.50%)和D组(57.60±8.40%比51.27±9.20%)。C组LVEF高于D组(54.33±8.50%比51.27±9.20%)。A、B组两组患者随访MACE发生率差异无统计学意义。但A组MACE发生率低于C组(14.1%比33.3%,χ2=6.164,P=0.012)和D组(14.1%比50.5%,χ2=19.392,P=0.001)。B组、C组两组患者随访MACE发生率差异无统计学意义(26.1%比33.3%,χ2=0.621,P=0.285)。但B组MACE发生率低于D组(26.1%比50.5%,χ2=6.674,P=0.008)。C组MACE发生率显著低于D组(33.3%比50.5%,χ2=3.582,P=0.044)。结论 STEMI患者PCI术后残余ST段抬高与患者住院期间左室EF值、6个月内MACE发生率相关。

关键词(KeyWords)： 心肌梗死;血管成形术,经腔,经皮冠状动脉;再灌注;残余ST段抬高总和

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李美红,牛杰,冯新恒,郭丽君,张福春,王贵松,郭静萱,高炜

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