摘要
目的:探讨急性心肌梗死(AMI)溶栓后60、90和180 min心电图sT段下降50％对早期临床预后的价值。方法:将95例AMI患者在溶栓后60、90和180 min记录的心电图分为ST段下降≥50％组和ST段下降<50％组,比较不同时期两组间36 d的心脏性死亡率和功能。结果:在每个研究时间与溶栓前基础心电图的ST段抬高最大导联比较,ST段下降<50％组较ST段下降≥50％组,心脏性死亡率和射血分数降低差异有显著性意义(P<0.01),且这一关系随梗死部位不同有变化。下壁梗死只有60 min心电图可预测心脏性死亡(P<0.05)。前壁梗死只有溶栓后60和90 min心电图ST段下降<50％组较ST段下降≥50％组左心功能明显下降(P<0.05)。结论:用心电图监测AMI溶栓后ST段的变化,是一种预测早期临床预后和检出高危患者简便而可靠的方法。AMI溶栓后60 min心电图预测临床预后似乎比90和180 min心电图更好。
Objective:To study the value of 50% decrease in ST segment elevation in standard 12-lead electro -cardograms(ECGs) recorded at 60,90 and 180 minutes after thrornbolysis therapy in acute myocardial infarction (AMI) for predicting its early prognosis. Methods:Ninty five AMI patients were divided into ST depression≥50% and ST depression<50% in standard 12-lead ECGs recorded at 60,90 and 180 minutes after thrornbolysis therapy. Cardiac mortality and left ventricular function in two groups at different times were analysed and compared with those on 36 days later. Results:ST depression<50% in the single lead of maximum ST segment elevation at each of the times studied was associated with a significantly higher cardiac mortality and lower ejection fraction than ST depression≥50%( P <0. 01). There was some variation according to infarct site with only the 60 minute ECG predicting mortality after inferior myocardial infarction(P<0. 05) and only the 60 and 90 minute ST elevation in anterior myocardial infarction was persistent associated with worse left ventricular function( P <0. 05). Conclusion:ST segment elevation in AMI patients after thrornbolysis therapy is an inexpensive and reliable index for predicting early prognosis and can identify high risk patients. ECG at 60 minutes is better for predicting early prognosis than at 90 and at 180 minutes after thrornbolysis for AMI.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2002年第11期562-564,共3页
Journal of Clinical Cardiology
