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急性ST段抬高心肌梗死患者再灌注心电图变化及其可能的影响因素
引用本文:杜林,伍勇,李伟.急性ST段抬高心肌梗死患者再灌注心电图变化及其可能的影响因素[J].中外医疗,2016(34).
作者姓名:杜林  伍勇  李伟
作者单位:扬州大学第二临床医学院心内科,江苏扬州,225000
摘    要:目的:对急性ST段抬高心肌梗死患者应用再灌注进行治疗的心电图变化及其可能的影响因素进行分析,为临床治疗工作提供依据。方法整群收集自2014年5月_2016年7月在该院所接受再灌注(溶栓或PCI﹚治疗的74例急性ST段抬高心肌梗死患者进行分析,对患者发生心律失常的概率、再灌注损伤性ST段抬高的出现率以及影响因素进行分析,根据再灌注治疗后心电图是否有损伤性改变分为再灌注损伤组和再灌注非损伤,其中再灌注损伤组29例和再灌注非损伤45例,对两组患者的静脉血中的白介素-6、超氧化物歧化酶、过氧化氢酶、总抗氧化力等指标进行比较。结果通过对74例急性ST段抬高心肌梗死患者进行分析发现:①43例发生心律失常,占所有研究对象的58.11%;33例再灌注损伤性ST段抬高出现,占所有研究对象的44.59%。②患者出现再灌注损伤性ST段抬高的主要影响因素为发病至CK达高峰时间、冠状动脉血管病变数目再灌注时间、性别、治疗时间、溶栓治疗以及PCI治疗,患者在经溶栓治疗的再灌注损伤性心电图改变发生率高于PCI。差异有统计学意义,P﹤0.05。③再灌注损伤性组的白介素-6量远远高于再灌注非损伤性组;超氧化物歧化酶、过氧化氢酶、总抗氧化力低于再灌注非损伤性组。差异有统计学意义,P﹤0.05。结论对急性ST段抬高心肌梗死患者应用再灌注进行治疗的心电图变化及其可能的影响因素进行分析,临床价值大。

关 键 词:再灌注心电图  急性ST段抬高心肌梗死患者  影响因素

The Changes of Electrocardiogram in Patients with Acute ST Segment Ele-vation Myocardial Infarction and its Possible Influencing Factors
Abstract:Objective Patients with acute ST segment elevation myocardial infarction treated with reperfusion of electrocar-diographic changes of treatment and its possible influencing factors were analyzed, so as to provide basis for clinical treat-ment. Methods Group selection collected in May 2014 to July 2016 in our hospital accepted treatment of 74 cases of acute ST segment elevation myocardial infarction patients were analyzed.In patients with arrhythmia of probability, reperfusion in-jury of ST segment elevation rate and influencing factors are analyzed, according to again after perfusion in the treatment of ECG is divided into reperfusion group and non reperfusion injury. The reperfusion injury group (29 cases) and non reperfu-sion injury: a report of 45 cases, the venous blood of patients in the two groups of reactive oxygen species (ROS), total an-tioxidant capacity and indexes were compared. Results The of 74 patients with acute ST segment elevation myocardial in-farction patients were analyzed. It is found that: 1. 43 cases occurred arrhythmias, accounting for 58.11%of all subjects, 33 patients with reperfusion injury of St segment elevation, accounting for all the studied object of 44.59%. 2 patients with reperfusion injury of ST segment elevation of main influencing factors for the onset and CK reached the peak time, number of coronary artery lesions reperfusion time, gender, treatment time, thrombolytic therapy and percutaneous coronary interven-tion (PCI). Patients in thrombolysis treatment of reperfusion injury of ECG change rate is higher than the PCI. The differ-ence was statistically significant, P < 0.05. The reperfusion injury of group of - glutamyl cysteine synthetase activity was higher than that of the non reperfusion injury group; glutathione, decreased total antioxidant capacity, malondialdehyde (MDA), increased reactive oxygen species. Difference was statistically significant,P< 0.05. Conclusion The death of acute ST segment elevation myocardial infarction patients with reperfusion of electrocardiographic changes of treatment and its possible influencing factors were analyzed, and the clinical value.
Keywords:Reperfusion electrocardiogram  Acute ST segment elevation myocardial infarction patients  Influencing factors
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