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目的 观察老年急性心肌梗死 (AMI)患者冠状动脉介入 (PCI)治疗成功后 ,校正的 TIMI帧数 (CTFC)与心电图 ST段回落联合评价心肌组织水平灌注的可行性。方法 选取接受 PCI治疗后血流达 TIMI3级的老年 AMI患者 42例 ,测定 CTFC,并在术前及术后 1月分别测定室壁运动记分 (WMSI)。观察 CTFC与 WMSI之间的相关性 ,同时检查术前及术后 1 h心电图 ST段回落情况。结果 按照 CTFC将 TIMI血流 3级者分为快、慢两组 ,快 CTFC组 ST段回落程度明显优于慢 CTFC组 ;一个月后快 CTFC组的 WMSI改善程度明显优于慢 CTFC组 ,CTFC与术前、术后WMSI的差值有明显的负相关 ;快 CTFC组患者从发病到接受 PCI治疗的时间明显短于慢 CTFC组。结论 CTFC作为一种定量、客观、简单、经济、重复性好的方法评价心肌微循环灌注情况 ,较低的 CTFC及心电图 ST段回落完全预示着良好的心功能恢复及临床预后 ,可为临床提供是否需要进一步辅助治疗的依据。
Objective To observe the feasibility of myocardial perfusion in patients with senile acute myocardial infarction (AMI) after successful coronary intervention (PCI). The corrected TIMI frames (CTFC) and electrocardiogram ST segment regression were evaluated. Methods Forty-two elderly AMI patients with TIMI 3 grade after PCI were enrolled in this study. The CTFC was measured and the wall motion score (WMSI) was measured before and after 1 month. The correlation between CTFC and WMSI was observed, and the fall of ST segment of ECG at 1 hour before and after operation was also observed. Results According to CTFC, TIMI blood flow grade 3 was divided into fast and slow groups. The ST-segment drop in fast CTFC group was better than that in slow CTFC group. The improvement of WMSI in fast CTFC group was obviously better than that in slow CTFC group after one month There was a significant negative correlation between WMSI and preoperative and postoperative WMSI. The incidence of PCI in fast CTFC group was significantly shorter than that in slow CTFC group. Conclusion CTFC as a quantitative, objective, simple, economical and reproducible method to evaluate myocardial microcirculation perfusion, lower CTFC and electrocardiogram ST segment depression completely predict the good recovery of cardiac function and clinical prognosis, can provide clinical Whether the need for further adjuvant treatment basis.