急性心肌梗死心肌组织再灌注的心电图ST段动态变化分析
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摘要
目的:探讨术前、术后即刻心电图表现与急性心肌梗死(AMI)心肌组织再灌注相关性。方法:对244例急性心肌梗死患者进行术前常规生化指标检测,分别在术前、术后即刻、术后12h,进行18导联心电图检测。结果:无复流者ST段抬高总和高于正常者(P<0.05);无复流者C型ST段抬高、再灌注心律失常均高于正常者(P<0.05);再灌注心律失常发生率、再灌注心律失常者发病时间、ST段抬高导联数目低于无再灌注心律失常者(P<0.05);术后24hCK-MB、cTnT水平低于术前(P<0.05);术后即刻、术前ST段抬高导联数目(r=0.542、r=487,P<0.05)、抬高总和下降幅度(r=0.563、0.539,P<0.05),与CK-MB、cTnT术后24h水平较术前下降幅度呈正相关;A组、B组、C组、D组无复流率与再灌注心律失常发生率差异有统计学意义(P<0.05)。结论:AMI再灌注与术前心电图有关,术后即刻心电图较术前是否改善,可作为再灌注心律失常预测指标。
Objective:Analysis of the correlation between the acute infarction(AMI)and the myocardial tissue reperfusion in patients with acute myocardial infarction(yocardial)before and after the operation.Methods:From patients with acute myocardial infarction admitted to hospital emergency department as the research object,Selected objects in 244 cases,Preoperative biochemical indexes were detected in the patients,before and after operation,12 h,18lead ECG detection.Results:The sum of ST segment elevation was higher than normal,C type ST segment elevation,reperfusion arrhythmia,Higher than normal,the difference was statistically significant(P<0.05);Reperfusion arrhythmia incidence,The time of onset of reperfusion arrhythmia and the number of ST segment elevation lead were lower than those without reperfusion arrhythmia,and the surprise was statistically significant(P<0.05);24hCK-MB and cTnT levels were lower than preoperative,and the difference was statistically significant(P<0.05);The number of ST segment elevation lead,and the sum of elevation were higher than that before operation,The level of 24 h was positively correlated with the decrease of level after cTnT and CK-MB;A group,B group,C group,D group,there was no significant difference in the incidence rate of reperfusion arrhythmia(P<0.05).Conclusion:AMI reperfusion was related to preoperative ECG,There was an improvement in the performance of the ECG immediately after operation,which can be used as the prediction index of reperfusion arrhythmias.
Objective:Analysis of the correlation between the acute infarction(AMI)and the myocardial tissue reperfusion in patients with acute myocardial infarction(yocardial)before and after the operation.Methods:From patients with acute myocardial infarction admitted to hospital emergency department as the research object,Selected objects in 244 cases,Preoperative biochemical indexes were detected in the patients,before and after operation,12 h,18lead ECG detection.Results:The sum of ST segment elevation was higher than normal,C type ST segment elevation,reperfusion arrhythmia,Higher than normal,the difference was statistically significant(P<0.05);Reperfusion arrhythmia incidence,The time of onset of reperfusion arrhythmia and the number of ST segment elevation lead were lower than those without reperfusion arrhythmia,and the surprise was statistically significant(P<0.05);24hCK-MB and cTnT levels were lower than preoperative,and the difference was statistically significant(P<0.05);The number of ST segment elevation lead,and the sum of elevation were higher than that before operation,The level of 24 h was positively correlated with the decrease of level after cTnT and CK-MB;A group,B group,C group,D group,there was no significant difference in the incidence rate of reperfusion arrhythmia(P<0.05).Conclusion:AMI reperfusion was related to preoperative ECG,There was an improvement in the performance of the ECG immediately after operation,which can be used as the prediction index of reperfusion arrhythmias.
引文
[1]卫生部心血管病防治研究中心.中国心血管病报告2015[M].北京:中国大百科全书出版社,2016:1-2.
[2]韦再华,高燕琳,苏建婷,等.2003-2007年北京户籍居民急性心肌梗死死亡人群分布特征[J].中华预防医学杂志,2012,46(7):651-652.
[3]杜文涛,刘秀平,张辉,等.缬沙坦对大鼠急性心肌梗死后血清脑钠肽、内皮素-1和左室重构的影响[J].陕西医学杂志,2013,42(12):1576-1577.
[4]王金波,张建维,曹树军,等.心肌梗死行冠状动脉介入治疗后无复流现象临床分析[J].中华实用诊断与治疗杂志,2014,28(3):236-238.
[5]胡佳,古君,许飞,等.EGCG对大鼠心肌缺血再灌注损伤的影响及作用机制探讨[J].四川大学学报,2016,47(3):305-309.
[6]陈少敏,李笛,崔鸣,等.直接经皮冠状动脉介入治疗急性心肌梗死患者血清组胺水平与心电图ST段回落的关系[J].北京大学学报,2014,46(6):875-878.
[2]韦再华,高燕琳,苏建婷,等.2003-2007年北京户籍居民急性心肌梗死死亡人群分布特征[J].中华预防医学杂志,2012,46(7):651-652.
[3]杜文涛,刘秀平,张辉,等.缬沙坦对大鼠急性心肌梗死后血清脑钠肽、内皮素-1和左室重构的影响[J].陕西医学杂志,2013,42(12):1576-1577.
[4]王金波,张建维,曹树军,等.心肌梗死行冠状动脉介入治疗后无复流现象临床分析[J].中华实用诊断与治疗杂志,2014,28(3):236-238.
[5]胡佳,古君,许飞,等.EGCG对大鼠心肌缺血再灌注损伤的影响及作用机制探讨[J].四川大学学报,2016,47(3):305-309.
[6]陈少敏,李笛,崔鸣,等.直接经皮冠状动脉介入治疗急性心肌梗死患者血清组胺水平与心电图ST段回落的关系[J].北京大学学报,2014,46(6):875-878.