首页|心电图ST-T变化与急性心肌梗死患者急诊经皮冠状动脉介入术预后的关系

心电图ST-T变化与急性心肌梗死患者急诊经皮冠状动脉介入术预后的关系

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[目的]探讨心电图 ST-T变化与急性心肌梗死(AMI)患者急诊经皮冠状动脉介入术(PCI)预后的关系.[方法]对本院行急诊PCI治疗的 244 例 AMI患者随访 6 个月,根据预后结局分为预后不良组和预后良好组,心电监护记录患者术前心电图 ST-T抬高及术后 1h、24h心电图 ST-T回落程度.分析影响预后的危险因素.评估术前及术后心电图 ST-T回落程度对 PCI手术预后的预测价值.[结果]244 例患者中预后不良 28 例,预后不良组发病至介入治疗时间、术后 1 个月左心室舒张末期内径(LVDd)水平均高于预后良好组(P<0.05);预后不良组术后 1 个月左室射血分数(LVEF)、术前至术后 1 h 及术前至术后 24h 心电图ST-T段回落程度均低于预后良好组(P<0.05).Logistic回归分析结果显示,发病至介入治疗时长延长、术后 1 个月 LVDd水平升高、术后 1 个月 LVEF水平降低、术前至术后 1 h及 24h心电图 ST-T段回落程度低均是 AMI患者PCI术后预后不良的危险因素(P<0.05).受试者工作特征(ROC)曲线分析结果显示,心电图术前至术后 1h 及 24hST-T段回落程度对PCI术后预后不良预测的曲线下面积分别为 0.721 和 0.718.[结论]心电图 ST-T演变与 AMI患者PCI术后预后的结局密切相关,且心电图 ST-T 回落程度可用于辅助预测患者的预后.
The Relationship between Changes in Electrocardiogram ST-T and Prognosis of Emergency Per-cutaneous Coronary Intervention in Patients with Acute Myocardial Infarction
[Objective]To investigate the relationship between the changes of ST-T segment in electrocar-diogram and the prognosis of patients with acute myocardial infarction(AMI)undergoing emergency percuta-neous coronary intervention(PCI).[Methods]A total of 244 patients with AMI who underwent PCI treatment in our hospital were followed up for 6 months.According to the prognosis,they were divided into a poor prog-nosis group and a good prognosis group,Electrocardiographic monitoring was used to record the ST-T eleva-tion before surgery and the degree of ST-T drop at 1 hour and 24 hours after surgery.The risk factors affecting prognosis were analyzed.The predictive value of ST-T drop in electrocardiogram before and after surgery for the prognosis of PCI surgery was evaluated.[Results]Among the 244 patients,28 had a poor prognosis.The time from onset to intervention treatment and the level of left ventricular end-diastolic diameter(LVDd)at 1 month after surgery in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The levels of left ventricular ejection fraction(LVEF)at 1 month after surgery and the degree of ST-T drop from pre-to post-1 hour and pre-to post-24 hours were lower than those in the good prognosis group(P<0.05).Logistic regression analysis showed that prolonging the time from onset to intervention treatment,in-creasing the level of LVDd at 1 month after surgery,reducing the level of LVEF at 1 month after surgery,and reducing the degree of ST-T drop from pre-to post-1 hour and pre-to post-24 hours were all risk factors for a poor prognosis in patients with AMI undergoing PCI surgery(P<0.05).Analysis of receiver operating char-acteristic curve showed that the area under the curve of ST-T drop in electrocardiogram from pre-to post-1 hour and 24 hours in predicting a poor prognosis after PCI surgery was 0.721 and 0.718,respectively.[Conclu-sion]The evolution of ST-T segment in electrocardiogram is closely related to the prognosis of patients with AMI undergoing PCI surgery,and the degree of ST-T drop in electrocardiogram can be used to predict the prognosis of patients.

Myocardial InfarctionAcute DiseaseAngioplasty,Balloon,CoronaryElectrocar-diographyPrognosis

薛姗娜、吴岩

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西安大兴医院急诊科,陕西 西安 710016

宝鸡市中医医院心血管内科,陕西 宝鸡 721001

心肌梗死 急性病 血管成形术,气囊,冠状动脉 心电描记术 预后

2024

医学临床研究
湖南省医学会

医学临床研究

影响因子:0.595
ISSN:1671-7171
年,卷(期):2024.41(2)
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