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目的探讨行急诊经皮冠状动脉介入治疗(PCI)术的急性ST段抬高型心肌梗死(STEMI)患者的ST段回落不良的相关因素。方法连续观察首都医科大学宣武医院2009年1月至2010年8月行急诊PCI,且术后TIMI血流3级的STEMI患者127例,以ST段回落是否≥50%,分为ST段完全回落组和ST段回落不良组,分析其临床特点,并探讨ST段回落不良的临床影响因素。结果两组基线资料比较,ST段回落不良组入院心率大于ST段完全回落组(80.3±11.9比73.3±17.5,P=0.023);其他基线资料两组间差异无统计学意义(均为P>0.05)。多因素分析显示,症状发作到冠状动脉开通时间(OR:0.998,95%CI:0.996~0.999,P=0.014)、左冠状动脉闭塞(OR:0.341,95%CI:0.122~0.951,P=0.040)是STEMI患者心电图ST段回落不良的独立危险因素。结论再灌注治疗时机和病变解剖部位与STEMI患者ST段回落不良有关。
Objective To investigate the related factors of poor ST-segment depression in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent emergency percutaneous coronary intervention (PCI). Methods A total of 127 STEMI patients who underwent emergency PCI at Xuanwu Hospital of Capital Medical University from January 2009 to August 2010 were retrospectively analyzed. Group and ST-segment depression group, analyze its clinical features, and explore the clinical factors affecting the ST-segment depression. Results The baseline heart rate was significantly higher in ST-segment dyspepsia group than in ST-segment STD group (80.3 ± 11.9 vs 73.3 ± 17.5, P = 0.023). There were no significant differences in other baseline data between the two groups (P> 0.05). Multivariate analysis showed that the time from the onset of symptoms to coronary artery opening (OR: 0.998, 95% CI: 0.996-0.999, P = 0.014) and left coronary artery occlusion (OR: 0.341, 95% CI: 0.122-0.95 1, P = ) Is an independent risk factor for poor ST-segment depression in STEMI patients. Conclusion The timing of reperfusion therapy and the anatomic site of lesion are related to the poor ST-segment depression in STEMI patients.