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| The Relationship between Changes in Electrocardiogram ST-T and Prognosis of Emergency Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction |
| XUE Shanna, WU Yan |
| Department of Emergency, Xi'an Daxing Hospital, Xi'an Shaanxi 710016 |
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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.
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Received: 15 February 2023
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[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. |
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2024, Vol. 41 
