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

doi:10.3969/j.issn.1671-7171.2024.02.016

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1181 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【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1 h、24 h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24 h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24 h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1 h 及24 h ST-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。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	薛姗娜
	吴岩

关键词 ：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

Abstract：【Objective】 To investigate the relationship between the changes of ST-T segment in electrocardiogram and the prognosis of patients with acute myocardial infarction (AMI) undergoing emergency percutaneous 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 prognosis group and a good prognosis group, Electrocardiographic monitoring was used to record the ST-T elevation 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, increasing 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 characteristic 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. 【Conclusion】 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.

Key words： Myocardial Infarction Acute Disease Angioplasty, Balloon, Coronary Electrocardiography Prognosis

收稿日期: 2023-02-15

中图分类号:

R542.22

通讯作者: *E-mail:17278373360@163.com

引用本文:

薛姗娜, 吴岩. 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[J]. 医学临床研究, 2024, 41(2): 214-217.
XUE Shanna, WU Yan. The Relationship between Changes in Electrocardiogram ST-T and Prognosis of Emergency Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction. JOURNAL OF CLINICAL RESEARCH, 2024, 41(2): 214-217.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.02.016 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I2/214

[1] 袁源,马兰,王黎,等. 急性心肌梗死患者PCI术前后心电图QRS-T夹角变化及其预后价值[J].现代生物医学进展,2021,21(23):4549-4553.
[2] 仇杰,谢勇,李雨涵,等. 入院时胸导联Q波总振幅与R波总振幅比值对急性ST段抬高型前壁心肌梗死患者急诊经皮冠状动脉介入治疗后短期预后的预测价值研究[J].实用心脑肺血管病杂志,2020,28(1):17-22.
[3] 王卉,马剡芳. 肝素联合阿替普酶静脉溶栓治疗急性ST段抬高型心肌梗死的效果[J].中国医药导报,2019,16(2):59-62.
[4] 马珍珍,卢小伟. 伴高血压的急性ST段抬高型心梗PCI术后动态心电图、血压对主要不良心脏事件的预测分析[J].中国循证心血管医学杂志,2022,14(6):721-726.
[5] 张文砚. 急性心肌梗死患者冠脉内血栓类型与心电图ST段改变的相关性研究[J].血栓与止血学,2019,25(1):8-10.
[6] 中华医学会心血管病学分会.急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J].中华心血管病杂志,2019,47(10):766-783.
[7] 陈晓敏,葛广豪,马江伟,等. 冠状动脉内逆向溶栓联合PCI对老年急性ST段抬高型心肌梗死预后的影响[J].疑难病杂志,2022,21(7):689-693.
[8] 钟晔,李春燕,张松文. 基于急性心肌梗死患者心电图表现的恶性室性心律失常风险预测模型的构建分析[J].心脑血管病防治,2021,21(5):497-499.
[9] 颜昌福,艾民,夏福纯,等. 急性ST段抬高型心肌梗死心电图缺血分级与经皮冠状动脉介入术后心血管事件的研究[J].四川医学,2019,40(2):121-124.
[10] 童惠平,原朵朵,张雪瑞. 心电图对急性ST段抬高型心肌梗死诊断价值及Tp-e值影响[J].贵州医药,2021,45(11):1797-1799.
[11] 陈文博,李文静,陈健,等. ST段抬高型急性前壁心肌梗死经皮冠状动脉介入治疗后心电图ST段及T波演变与左心功能恢复关系分析[J].山西医药杂志,2019,48(23):2964-2965.
[12] 卢小伟,刘亚东. 急性心肌梗死患者心肌复极异常心电图表现及其与恶性心律失常的关系研究[J].实用心脑肺血管病杂志,2019,27(8):41-45.
[13] 张美婷,刘宏,汤日宁. 校正后Tp-Te间期和校正后QT间期及Tp-Te/QT比值对急性ST段抬高型心肌梗死患者溶栓治疗后恶性心律失常及不良预后的预测价值[J].中国医药,2021,16(1):33-37.
[14] 赵汉如,侯丽芳,周单,等. 心电图联合血清氨基末端脑钠肽前体对急性心肌梗死患者择期经皮冠状动脉介入治疗后近期发生主要不良心血管事件的预测价值研究[J].实用心脑肺血管病杂志,2021,29(4):32-37.
[15] 王文强,程景民. 急性心肌梗死PCI介入治疗延迟的原因及其对患者预后的影响[J].中国医师杂志,2019,21(12):1868-1871.
[16] 孙璐,许长存,侯玉萍. 急性前壁心肌梗死患者静脉溶栓后不同时间行经皮冠状动脉介入治疗的对比研究[J].中国循证心血管医学杂志,2021,13(2):231-235.