急性心肌梗死后左心功能及室壁运动恢复与ST段的变化关系
徐琳,胡大一,吴雅峰,边红,吴江
摘要(Abstract)：
目的 探讨急性心肌梗死 (AMI)患者接受直接经皮冠状动脉腔内成形术 (PTCA)治疗后左室收缩功能及梗死区室壁运动恢复与心电图抬高ST下降幅度的关系。方法 接受直接PTCA的AMI患者共 34例 ,比较PTCA前及术后 1h 12导联心电图抬高ST段的总和 ,按ST段下降幅度分为两组 :A组 :ST段下降≥ 5 0 % ;B组 :ST段下降 <5 0 %。所有患者于发病第 (7± 2 )d行小剂量多巴酚丁胺超声心动图负荷试验并于发病第 1、2、3个月行超声心动图检查。结果 AMI发病急性期基础状态和负荷状态及发病后第 1、2、3个月左室射血分数 (LVEF)A组均明显大于B组 (6 3 4vs 5 6 7;6 8 9vs6 0 5 ;6 0 1vs5 3 1;6 1 4vs 5 3 1;6 0 9vs 5 2 3 ;P均 <0 0 5 )。基础状态和多巴酚丁胺负荷状态下总室壁运动积分指数 (GWMSI)和梗死区室壁运动积分指数 (IWMSI)A组均明显小于B组。AMI发病第 1、2、3个月GWMSIA组均明显小于B组 (1 2 1vs 1 38,P =0 0 42 ;1 17vs 1 38,P =0 0 15 ;1 18vs 1 30 ,P =0 0 35 )。发病第 1、2个月IWMST两组间无统计学差异。发病第 3个月IWMSTA组明显小于B组(2 16vs 2 47,P =0 0 48)。结论 急性心肌梗死直接PTCA后心电图ST段下降幅度≥ 5 0 %组在AMI急性期和恢复期左室收缩功能及梗死区室壁运动的恢复均明显优于S
关键词(KeyWords)： 心肌梗塞;心电图;超声心动图
基金项目(Foundation): 卫生部默沙东基金
作者(Author): 徐琳,胡大一,吴雅峰,边红,吴江
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