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目的探讨溶栓后早期T波倒置对闭塞冠状动脉再通的诊断价值及预后。方法选择78例急性心肌梗死(AMI)接受溶栓治疗的患者,分为24h内T波倒置组和未倒置组,依据临床间接血管再通标准观察两组再通情况。结果早期T波倒置组与未倒置组比较,前者较后者:①血管再通率高(p<0.01);②心肌酶酶峰明显提前,峰值显著下降(p<0.05);③心电图ST段迅速回降(p<0.01);④再灌注心律失常的发生率高(p<0.01);⑤心脏事件发生率低(p<0.05);⑥半年后左室LVEF改善明显(p<0.05)。结论早期T波倒置可作为冠脉再通的无创性可靠指标有助于检出高危患者。
Objective To investigate the diagnostic value and prognosis of recanalization of occluded coronary artery by T wave inversion after thrombolysis. Methods Totally 78 patients with acute myocardial infarction (AMI) undergoing thrombolytic therapy were divided into 24 hours in T wave inversion group and non-inversion group. According to the standard of clinical indirect recanalization, the recanalization was observed. Results Compared with the untreated group, the former had higher recanalization rate (p <0.01); ② The enzyme peak of myocardial enzymes was significantly earlier and the peak value decreased significantly (p <0.05); ③ The ST segment (P <0.01); ④ The incidence of reperfusion arrhythmia was high (p <0.01); ⑤ The incidence of cardiac events was low (p <0.05); ⑥ The left ventricular LVEF improved significantly after six months (p <0.05). Conclusion Early T wave inversion can be used as a noninvasive and reliable indicator of coronary recanalization to help detect high risk patients.