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目的探讨心电图梗死相关导联持续ST段抬高对判断直接PCI治疗AMI疗效的应用价值。方法根据心电图梗死相关导联ST段抬高回落情况将229例直接PCI后TIMI血流3级的AMI患者分2组:ST段回落>50%组(甲组),147例;与ST段回落<50%组(乙组),82例,比较两组一般临床特征,随访心血管事件的发生率。结果甲乙两组:无复流(blush分级<2级)为14/147(9.5%)和21/82(25.6%);住院期间病死率5/147(3.40%)和9/82(11.0%);MACE 8/147(5.4%)和11/82(13.4%);心功能EF数值56.99±9.78和49.82±8.78比较,P<0.05,均有明显统计学差异。随访期间病死率2/147(1.34%)和3/82(3.7%);MACE 10/147(5.4%)和7/82(8.5%),P>0.05,均无统计学差异。结论心电图梗死相关导联ST段抬高回落情况可作为直接PCI后心肌组织水平再灌注及预后判断的指标。
Objective To investigate the value of ST-segment elevation induced by ECG-related lead in judging the efficacy of direct PCI for AMI. Methods 229 AMI patients with grade 3 TIMI grade III after PCI were divided into two groups according to ST-segment elevation and fall-off status of ECG-related lead: 147 cases with ST-segment depression> 50% (Group A) and 147 cases with ST-segment depression <50% (group B), 82 cases. The clinical features of the two groups were compared and the incidence of cardiovascular events was followed up. Results There were 14/147 (9.5%) and 21/82 (25.6%) no-reflow (grade 2 blush) and 5/147 (3.40%) and 9/82 (11.0% ); MACE 8/147 (5.4%) and 11/82 (13.4%); EF of heart function values 56.99 ± 9.78 and 49.82 ± 8.78, P <0.05, there was a statistically significant difference. Mortality rates during follow-up were 2/147 (1.34%) and 3/82 (3.7%); MACE 10/147 (5.4%) and 7/82 (8.5%), respectively, with no significant difference. Conclusion ST-segment elevation and fall-back in the lead of ECG infarction can be used as indicators of the level of myocardial reperfusion and prognosis after PCI.