急性心肌梗死患者溶栓前ST段偏移总和值的预示价值

目的:探讨急性心肌梗死（AM I）患者溶栓前ST段偏移总和值对院内心功能情况的预示价值。方法:序贯入选我院心内科1997年2003年收治的首次发生AM I并接受溶栓治疗的患者,记录并对其临床资料进行回顾性分析。结果:符合入选标准的患者有136例,40例患者院内发生心功能不全,占29.4%。以溶栓前ST段偏移总和值将患者分为A组、B组、C组,组间比较:溶栓前ST段偏移总和值越高,患者院内心功能不全的发生率越高。Logis-tic多因素逐步回归分析显示:溶栓前ST段偏移总和值是该组患者院内发生心功能不全的独立危险因素,关联强度（OR值）为2.992（P=0.006）。结论:溶栓前ST段偏移总和值指标有助于早期识别发生院内心功能不全的高危AM I患者,以加强治疗,改善预后。

The prognostic values of the summation of ST segment deviation after acute myocardial infarction

AIM: To investigate the prognostic significance of the summation of ST segment deviation for in hospital heart failure in patients who had suffered from acute myocardial infarction(AMI) and undergone thrombolysis therapy. METHODS: Retrospective analysis was performed for all the hospitalized patients of our department from 1997 to 2003 who had undergone the first AMI and thrombolysis therapy. RESULTS: 136 patients met the entry criteria. Heart failure occurred to 40 patients(29.4%). The patients were divided into three groups according to the summation of ST segment deviation. The analysis of variance for the difference in the three groups manifested that the higher the value for the summation of ST segment deviation, the greater the probability of heart failure occurance during hospitalization. In the multivaritate logistic regression analysis and forward stepwise selection, the summation of ST segment deviation before thrombolysis therapy was one of the independent risk factors of heart failure during hospitalization. The odds ratio value was 2.992 (P0.006). CONCLUSION: Evaluating the summation of ST segment deviation will contribute to the identification of high risk of heart failure occurrence among the patients who have undergone the first AMI and to better therapy and prognosis.