CAJ | 학술논문

目的：评价ST段抬高心肌梗死（ST-segment elevation myocardial infarction，STEMI）患者急诊冠脉介入（percutaneous coronary intervention，PCI）术后心肌再灌注的预测指标。方法选择发病12 h内接受直接PCI治疗的STEMI患者176例，根据术后TIMI血流分级分为A组（TIMI 3级，灌注良好组），B组（TIMI 0-2级，灌注不良组）。采用心电图ST段回落、心肌损伤标志物水平进行分析。结果灌注不良组患者心电图ST段术后1 h回落不佳；CK-MB水平B组明显高于A组（P＜0．01），且峰值持续时间长；术后BNP水平B 组明显高于A 组（P＜0．05）；术后1周B组LVEF值明显低于A组（P＜0．05）。结论 ST段早期回落是STEMI患者急诊PCI术后心肌再灌注的有效预测指标，与心肌损伤标志物水平升高一致。
목적：평개ST단태고심기경사（ST-segment elevation myocardial infarction，STEMI）환자급진관맥개입（percutaneous coronary intervention，PCI）술후심기재관주적예측지표。방법선택발병12 h내접수직접PCI치료적STEMI환자176례，근거술후TIMI혈류분급분위A조（TIMI 3급，관주량호조），B조（TIMI 0-2급，관주불량조）。채용심전도ST단회락、심기손상표지물수평진행분석。결과관주불량조환자심전도ST단술후1 h회락불가；CK-MB수평B조명현고우A조（P＜0．01），차봉치지속시간장；술후BNP수평B 조명현고우A 조（P＜0．05）；술후1주B조LVEF치명현저우A조（P＜0．05）。결론 ST단조기회락시STEMI환자급진PCI술후심기재관주적유효예측지표，여심기손상표지물수평승고일치。
Objective ToevaluatethepredictiveindexofmyocardialreflowinpatientswithST-segment elevation myocardial infarction (STEMI ) undergoing percutaneous coronary intervention (PCI).Methods Onehundredandseventy-sixSTEMIpatientswereenrolledwhohadundergone PCI treatment within 1 2 hours since STEMI attacked.According to postoperative TIMI blood flow clas-sification,they were divided into group A (TIMI at level 3,perfusion group)and group B (TIMI at level 0-2,hypoperfusion group).The results were analyzed by the fall of ST-segment on ECG and thelevelofmyocardialinjurymarkers.Results ForpatientsingroupB,ST-segmentfellinsufficient-ly one hour after PCI.The level of CK-MB in group B was significantly higher than that in group A (P<0.01 )and the duration of peak value of CK-MB in group B was longer.The level of postoperative BNP in group B was significantly higher than that in group A (P<0.05 ).One week after PCI,the valueofLVEFwassignificantlyloweringroupBthanthatingroupA(P<0.05).Conclusion Ear-ly ST-segment fall proves to be an effective predictor of myocardial reperfusion in STEMI patients un-dergoing primary PCI,which is consistent with the increase of the level of myocardial injury markers.