摘要
本文对36例首次急性心肌梗塞患者作心电图和左心室及冠(状动)脉造影测定,19例梗塞区冠脉不完全阻塞(再通甲组)和17例梗塞区冠脉完全阻塞(乙组)。两组相比,甲组梗塞后4和8小时内ST段抬高总和(EST)显著下降。8小时内甲组中15例而乙组中无1例∑ST下降≥35％(敏感性为79％,特异性为100％,准确性为89％)。甲组中出院前病理性Q波导联数和QRS积分较乙组明显降低,而左心室功能明显优于乙组。提示,心肌梗塞后8小时内抬高的∑ST段降低≥35％预示梗塞区冠状动脉再通,后者对左心室功能具有重要的保护作用。
Serial electrocardiograms were recorded soon after admission and left ventriculography as well as coronary arteriography were performed at discharge in 36 patients with afirst transmural myocardial infarction.Among them, infarcted-related artery (IRA) was subtotally occluded in 19 patients (group Ⅰ) and totally occluded in 17 patients (group Ⅱ). The patients in group Ⅰ had a significant reduction in sum of ST segment elevation(∑ST)within 4 and 8 hours after infarction as compared with the patients in group Ⅱ. Fifteen patients in group Ⅰ and none in group Ⅱ had ∑ST reduction of 35% or greater of its initial value. The number of leads with pathologic Q waves and QRS score were lower and left ventricular ejection fraction was higher ir group Ⅰ. The present study indicates that a signifeant reduction in ∑ST (35% or greater of its initial value)within 8 hours after infarction may predict spontaneous recanalization of IRA, and the recanalization of IRA may preserve left ventricular function in patients with acute myocardial infarction.
出处
《上海医学》
CAS
CSCD
北大核心
1989年第7期389-391,共3页
Shanghai Medical Journal
