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目的 探讨急性心肌梗死 (AMI)病人梗死相关动脉 (IRA)再通对晚电位 (VLP)的动态影响。方法 AMI患者 3 8例 ,于溶栓开始前佩戴数字化Holter记录仪进行 2 4h的长程晚电位连续监测 ,然后将病人分设两个亚组 :溶栓成功组与溶栓不成功组 ,比较这两组病人在溶栓前后VLP各项参数的变化情况 ,找出其与冠脉再通情况之间的关系。结果 AMI患者在溶栓前和溶栓后 3 0min内 ,VLP各项参数无明显统计学差异 ,而溶栓 2～ 3h后 ,再灌注组VLP各参数的数值明显变化 ,而无再灌注组则无这种变化。结论 再灌注在迅速恢复心肌缺血的情况下 ,于溶栓后早期可显著降低VLP的发生率 ,这不仅为临床提供了又一种新的评价冠脉再通的无创检测方法 ,且纠正了传统认为的VLP只有在心肌纤维瘢痕的基础上才能形成的认识
Objective To investigate the dynamic effects of recanalization of infarct-related artery (IRA) on late potentials (VLPs) in patients with acute myocardial infarction (AMI). Methods Thirty-eight AMI patients were enrolled in the study. The digital holter recorder was worn before the start of thrombolysis to monitor the long-term late potentials of 24 hours continuously. The patients were divided into two subgroups: successful thrombolysis group and unsuccessful thrombolysis group Group of patients before and after thrombolysis of VLP parameters of the changes, to find out the relationship with the recanalization of the coronary artery. Results The parameters of VLP in AMI patients before thrombolytic therapy and within 30 minutes after thrombolysis had no significant difference. After thrombolysis for 2 ~ 3 hours, the values of VLP parameters in reperfusion group changed significantly, but no reperfusion group No such change. Conclusion In the case of rapid myocardial ischemia, reperfusion can significantly reduce the incidence of VLP after thrombolysis, which not only provides a new noninvasive method for evaluating coronary recanalization but also corrects Traditionally, VLPs are only recognized on the basis of myocardial fiber scar formation