急性心肌梗死直接PTCA术后1小时ST段变化对近期预后的评估

目的　探讨急性心肌梗死直接PTCA术后1hST段变化对急性期预后的评估意义。方法　观察接受直接PTCA的病人5 0例。比较入院时心电图抬高的ST段和术后1h抬高的ST段。按抬高的ST段下移>5 0 %或<5 0 % ,分为A组(2 9例)和B组(2 1例)。对比其急性期临床资料和心功能情况。结果　B组病人住院期间、易出现急性左心衰、射血分数较低。结论　急性心肌梗死直接PTCA术后1hST段变化,反映心肌再灌注治疗后的微循环情况,是预测早期临床预后和检出高危患者的简便而可靠的方法。

Prognostic value of the resolution of ST segment elevation one hour after primary PTCA in acute myocardial infarction

Objective To study the significance of the resolution of ST segment elevation one hour after primary PTCA in acute myocardial infarction. Methods 50 patients of acute myocardial infarction after primary PTCA were observed. All patients were divided into two groups by comparing the ST segment elevation immediately after hospitalization and ST segment one hour after primary PTCA: group A(29 cases),the resolution of ST segment>50%;group B (21 cases),the resolution of ST segment<50%.Compared the clinical information and cardiac function by echocardiography in acute period. Results The patients in group B had a higher incidence of mortality and left heart failure with poor cardiac function. Conclusion The change of ST segment elevation one hour after primary PTCA reflect the macro-circulation condition after reperfusion. It is a convenient and reliable method to predict acute prognosis and find out the high risk patients.