早期T波倒置对判断梗塞相关动脉开通的临床价值(摘要)
作者：李瑞杰 胡大一 郭成军 杨新春 商丽华 郭晋萍 贾三庆 李田昌
单位：北京市，首都医科大学心血管疾病研究所 北京红十字朝阳医院 心脏中心(100020)
关键词：
中国循环杂志99zk82 目的：探讨急性心肌梗塞(AMI)早期T波倒置对判断梗塞相关动脉(IRA)开通的临床价值。
方法：对发病≤6小时的61例(男46例、女15例，年龄39～80岁)AMI患者以动态心电图持续24小时监测T波变化，并与冠状动脉造影结果作对照。
结果：再灌注治疗患者，再灌注后T波正向振幅显著降低同时呈现T波倒置并逐渐加深，其中溶栓治疗成功的24例于发病的2～30(8.6±7.4)小时、距再灌注0～22(3.5±6.3)小时均显现T波倒置，接受直接经皮冠状脉腔内成形术治疗的22例于发病的2～11(5.9±2.5)小时、距再灌注0～9(1.9±2.7)小时均显现T波倒置。而15例IRA未开通患者在监测期间T波多正向，仅2例见T波倒置。
结论：AMI患者T波倒置的早期出现，对判断IRA开通有较高的敏感性和特异性。
The Clinical Value of Early T Wave Inversion in Determining the Patency of Infarct-Related Arteries (Abstract)
The Heart Center, Beijing Red Cross Chaoyang Hospital,The Institute of Cardiovascular Disease, Capital University of Medical Sciences, Beijing (100020)
Li Ruijie, Hu Dayi, Guo Chengjun, et al.
Objective: To evaluate the clinical value of early T wave inversion in determining the patency of infarct-related arteries (IRA).
Methods: Sixty-one patients (46 males and 15 females, ages 39～80) with acute myocardial infarction (AMI) were divided in 3 groups (noreperfusion, 15 cases; successful thrombolysis, 24 cases; and primary percutaneous transluminal coronary angioplasty, 22 cases) and underwent 24 hours Holter monitoring within 6 hours from the onset of the symptom. The T wave changes were compared with the results of coronary angiography.
Results: In the patients who had successful reperfusion the upright amplitude of T wave became lower obviously and the earlier T wave inversion after reperfusion was observed, while in those who had occluded IRA the upright amplitude of T waves were still higher and fewer cases had the early T wave inversion.
Conclusion: The early T wave inversion after intervention in AMI had both the high sensitivity (100%) and speciality (86.7%) in predicting the patency of IRA., 百拇医药
单位：北京市，首都医科大学心血管疾病研究所 北京红十字朝阳医院 心脏中心(100020)
关键词：
中国循环杂志99zk82 目的：探讨急性心肌梗塞(AMI)早期T波倒置对判断梗塞相关动脉(IRA)开通的临床价值。
方法：对发病≤6小时的61例(男46例、女15例，年龄39～80岁)AMI患者以动态心电图持续24小时监测T波变化，并与冠状动脉造影结果作对照。
结果：再灌注治疗患者，再灌注后T波正向振幅显著降低同时呈现T波倒置并逐渐加深，其中溶栓治疗成功的24例于发病的2～30(8.6±7.4)小时、距再灌注0～22(3.5±6.3)小时均显现T波倒置，接受直接经皮冠状脉腔内成形术治疗的22例于发病的2～11(5.9±2.5)小时、距再灌注0～9(1.9±2.7)小时均显现T波倒置。而15例IRA未开通患者在监测期间T波多正向，仅2例见T波倒置。
结论：AMI患者T波倒置的早期出现，对判断IRA开通有较高的敏感性和特异性。
The Clinical Value of Early T Wave Inversion in Determining the Patency of Infarct-Related Arteries (Abstract)
The Heart Center, Beijing Red Cross Chaoyang Hospital,The Institute of Cardiovascular Disease, Capital University of Medical Sciences, Beijing (100020)
Li Ruijie, Hu Dayi, Guo Chengjun, et al.
Objective: To evaluate the clinical value of early T wave inversion in determining the patency of infarct-related arteries (IRA).
Methods: Sixty-one patients (46 males and 15 females, ages 39～80) with acute myocardial infarction (AMI) were divided in 3 groups (noreperfusion, 15 cases; successful thrombolysis, 24 cases; and primary percutaneous transluminal coronary angioplasty, 22 cases) and underwent 24 hours Holter monitoring within 6 hours from the onset of the symptom. The T wave changes were compared with the results of coronary angiography.
Results: In the patients who had successful reperfusion the upright amplitude of T wave became lower obviously and the earlier T wave inversion after reperfusion was observed, while in those who had occluded IRA the upright amplitude of T waves were still higher and fewer cases had the early T wave inversion.
Conclusion: The early T wave inversion after intervention in AMI had both the high sensitivity (100%) and speciality (86.7%) in predicting the patency of IRA., 百拇医药