摘要
目的：评价急性心肌梗死（ＡＭＩ）冠状动脉再通后血流缓慢的临床意义。方法：５０例急性心肌梗死患者行静脉溶栓或经皮冠状动脉腔内成形术（ＰＴＣＡ），使梗死相关冠状动脉再通。相关冠状动脉血流心肌梗死溶栓试验（ＴＩＭＩ）计帧法示１５例血流缓慢（血流缓慢组），３５例血流正常（血流正常组）。结果：左心室造影血流缓慢组较血流正常组收缩末期容量增大，射血分数减低。血流缓慢组９０分钟后抬高ＳＴ段总和回落小于血流正常组，血流缓慢组ＱＲＳ波群积分和肌酸激酶峰值及其距发病时间大于血流正常组。住院期间血流缓慢组心脏事件发生率（４６．７％）显著高于血流正常组（８．６％，Ｐ＜０．０５）。出院前超声心动图检查显示，血流缓慢组收缩末期容量大于血流正常组，而射血分数低于血流正常组。结论：ＡＭＩ患者相关冠状动脉再通后血流缓慢提示心肌梗死面积大、心功能较差、预后不良。
? Objective:To assess the clinical significance of slow-flow phenomenon observed on angiography after coronary artery recanalization in patients with acute myocardial infarction(AMI) Methods:Coronary flow of the infarctrelated artery (IRA) was evaluated with thrombolysis in myocardial infarction trial(TIMI)frame count method in 50 patients with AMI after successful recanalization by thrombolysis or percutaneous transluminal coronary angioplastyCoronary flow was slow in 15 (group 1) and was normal in 35 patients (group 2) Results:Left ventriculography 90 min after thrombolysis showed that left ventricular endsystolic volume was significantly larger and ejection fraction was lower in group 1 than in group 2(both p<005)QRS score and peak creatine kinase were significantly higher in group 1(both p<005 vsgroup 2)The sum of ST segment elevation decreased less but the time to peak creatine kinase from the onset of symptoms was longer in group 1The incidence of cardiac event during hospitalization was higher in group 1(467%)than in group 2(86%,p<005)Predischarge echocardiography showed that left ventricular endsystolic volume was significantly larger and ejection fraction was lower in group 1(both p<005 vsgroup 2) Conclusion:The slowflow phenomenon in patients with AMI after successful recanalization may indicate larger infarct site,lower left ventricular function and worse prognosis
出处
《中国循环杂志》
CSCD
北大核心
1998年第1期7-9,共3页
Chinese Circulation Journal
