论文部分内容阅读
目的：评价急性心肌梗死（ＡＭＩ）冠状动脉再通后血流缓慢的临床意义。方法：５０例急性心肌梗死患者行静脉溶栓或经皮冠状动脉腔内成形术（ＰＴＣＡ），使梗死相关冠状动脉再通。相关冠状动脉血流心肌梗死溶栓试验（ＴＩＭＩ）计帧法示１５例血流缓慢（血流缓慢组），３５例血流正常（血流正常组）。结果：左心室造影血流缓慢组较血流正常组收缩末期容量增大，射血分数减低。血流缓慢组９０分钟后抬高ＳＴ段总和回落小于血流正常组，血流缓慢组ＱＲＳ波群积分和肌酸激酶峰值及其距发病时间大于血流正常组。住院期间血流缓慢组心脏事件发生率（４６．７％）显著高于血流正常组（８．６％，Ｐ＜０．０５）。出院前超声心动图检查显示，血流缓慢组收缩末期容量大于血流正常组，而射血分数低于血流正常组。结论：ＡＭＩ患者相关冠状动脉再通后血流缓慢提示心肌梗死面积大、心功能较差、预后不良。
Objective: To evaluate the clinical significance of slowing blood flow after coronary reperfusion in acute myocardial infarction (AMI). Methods: Fifty patients with acute myocardial infarction underwent intravenous thrombolysis or percutaneous transluminal coronary angioplasty (PTCA) to recanalize infarct-related coronary arteries. Related coronary artery thrombolysis thrombolysis test (TIMI) meter frame method showed 15 cases of slow blood flow (slow flow group), 35 cases of normal blood flow (normal blood flow group). Results: Compared with the normal group, the volume of left ventricular systolic blood flow increased slowly and the ejection fraction decreased. After 90 minutes of slow blood flow, the sum of ST segment depression decreased less than that of normal blood flow group. The QRS wave group score and creatine kinase peak in slow flow group were longer than those in normal blood flow group. During the hospital stay, the incidence of cardiac events in slow flow group (46.7%) was significantly higher than that in normal blood flow group (8.6%, P <0.05). Echocardiographic examination before discharge showed that the end-systolic volume of the slow-flow group was larger than that of the normal-flow group, while ejection fraction was lower than that of the normal-flow group. Conclusion: AMI patients with recanalization of the coronary arteries after the slow flow of blood flow prompted myocardial infarction area, poor heart function, poor prognosis.