急性心肌梗塞静脉溶栓治疗冠脉再通者早期ST段再抬高的临床意义

急性心肌梗塞早期静脉溶栓治疗后，一些溶栓再通患者中，可见早期降低的ＳＴ段再度出现抬高现象。本文回顾溶栓成功者８１例，其中早期出现ＳＴ段再度抬高者２１例（占３５％），与ＳＴ段非再度抬高者相比，ＣＰＫ、ＣＰＫ－ＭＢ峰值，心功能及院内死亡率等无显著差异。笔者认为，此现象也为再通的标志之一。因此，急性心肌梗塞溶栓治疗的早期连续监测心电图对确认再通与否非常重要

Clinical Significance of ST Re elevation During Early Reperfusion After Successful Thrombolysis in Acute Myocardial Infarction

In some AMI patients, ST re elevation occasionally occurs during the early hours of thrombolysis. The objective of this retrospective study was to investigate the clinical significance of ST re elevation at reperfusion. In 81 patients with AMI after successful thrombolysis, there were 21 with ST re elevation(35%). Between the groups with and without re elevation there was on significant difference in left ventricular function, occurrent time of peak CK and CK MB, and in hospital mortality. Our data suggested that the ECG pattern of ST re elevation of early reperfusion may be indicative for recognizing reperfusion. It is important to monitor ECG early and continuously for proving successful reperfusion. It should also be decided with the consideration of other non invasive markers used to predict reperfusion, such as relief from chest pain, reperfusion arrhythmia and early peak of serum CK level.