摘要
①目的研究校正的TIMI计帧法(CTFC)对ST段抬高的急性心肌梗死(STEMI)急诊经皮冠状动脉介入治疗术(PCI)后心肌血流灌注的诊断价值.②方法对170例STEMI行急诊PCI,选取其中达到TIMIⅢ级血流的病人150例,测定其CTFC;术前5 min和术后30 min行12~18导联心电图检查,观察术前、术后ST段下降情况,28 d后行超声心动图检查,分别测定其左心室短轴缩短率(FS)和左心窒射血分数(EF).③结果150例TIMIⅢ级血流病人中,CTFC检查示正常血流灌注者仅102例,占68%,慢血流灌注者48例.正常血流灌注病人的病死率低于慢血流灌注病人(x2=5.25,P<0.05),ST段回落率高于慢血流灌注病人(x2=31.34,P<0.01),FS和EF值高于慢血流灌注病人,差异均有显著性(t=5.85、6.51,P<0.01).④结论CTFC对心肌血流灌注诊断优于TIMI分级法,可以作为评价STEMI病人PCI术后心肌血流灌注的手段之一.
Objective To explore the diagnostic value of corrected frame count (CTFC) on myocardial reperfusion of ST- segment elevation acute myocardial infarction (STEMI) in patients with emergency percutaneous coronary intervention (PCI). Methods In all 170 cases of ST-segment elevation acute myocardial infarction treated with emergency PCI, 150 cases with TIMI 3 grade were selected. Their CTFC was determined, 12 or 18 leads electrocardiography was done at 5 minutes before operation and 30 minutes after operation, the condition of ST-segment degression was observed, and echocardiography done after 28 days and their FS and EF determined. Results Only 102 cases (68%) had normal flow in the 150 cases with TIMI 3 grade flow. Patients with normal flow had a lower mortality (X^2=5. 25,P〈0. 05) and higher FS and EF (t=5.85,6.51; P〈0.01) than those with slow flow. Conclusion CTFC is better than TIMI flow grade classification in estimating myocardial perfusion. It can be one of the most important diagnostic methods for myocardial perfusion of ST-segment elevation acute myocardial infarction after undergoing PCI.
出处
《齐鲁医学杂志》
2005年第4期283-285,共3页
Medical Journal of Qilu
关键词
心肌梗死
血管成形术
经腔
经皮冠状动脉
心肌再灌注
myocardial infarction
angioplasty, transluminal, percutaneous coronary
myocardial reperfusion