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目的:探讨急性心肌梗死(AMI)溶栓后60、90和180 min心电图sT段下降50％对早期临床预后的价值。方法:将95例AMI患者在溶栓后60、90和180 min记录的心电图分为ST段下降≥50％组和ST段下降<50％组,比较不同时期两组间36 d的心脏性死亡率和功能。结果:在每个研究时间与溶栓前基础心电图的ST段抬高最大导联比较,ST段下降<50％组较ST段下降≥50％组,心脏性死亡率和射血分数降低差异有显著性意义(P<0.01),且这一关系随梗死部位不同有变化。下壁梗死只有60 min心电图可预测心脏性死亡(P<0.05)。前壁梗死只有溶栓后60和90 min心电图ST段下降<50％组较ST段下降≥50％组左心功能明显下降(P<0.05)。结论:用心电图监测AMI溶栓后ST段的变化,是一种预测早期临床预后和检出高危患者简便而可靠的方法。AMI溶栓后60 min心电图预测临床预后似乎比90和180 min心电图更好。
Objective: To investigate the value of 50% reduction of sT segment at 60, 90 and 180 min after acute myocardial infarction (AMI) thrombolysis in early clinical prognosis. Methods: The electrocardiogram recorded in 95 patients with AMI at 60, 90 and 180 min after thrombolysis were divided into ST-segment depression≥50% and ST-segment depression <50%. The cardiac death at different time points was compared between the two groups Rate and function. Results: Compared with the maximum lead of ST segment elevation in basic electrocardiogram before thrombolysis at each study time, there was a significant difference between ST segment depression <50% group and ST segment depression> 50%, and cardiac death rate and ejection fraction decrease Significant significance (P <0.01), and this relationship varies with the infarct site. Cardiac death was predicted only 60 min after inferior wall infarction (P <0.05). In the anterior wall infarction, the left ventricular function was significantly decreased (P <0.05) in ST-segment decreased more than 50% in 60% and 90% of ST-segment electrocardiogram in 50% CONCLUSIONS: ECG changes in ST segment after AMI thrombolysis are a simple and reliable method for predicting early clinical outcomes and detecting high-risk patients. The 60-min ECG prediction of AMI after AMI seems to have a better clinical outcome than 90 and 180 min electrocardiograms.