Tranchesi Júnior B, Caramelli B, Gebara O C, Albuquerque C P, Bellotti G, Jatene A D, Pileggi F
Instituto do Coração do Hospital das Clínicas, FMUSP.
Arq Bras Cardiol. 1990 Oct;55(4):233-6.
To evaluate the importance of the segment ST in the identification of coronary recanalization in patients submitted to intravenous thrombolysis during acute myocardial infarction (MI).
Seventy four patients with MI, 62 male with mean age of 52.6 +/- 10 years. All patients had angiographically demonstrated occlusion of the infarct-related artery (IRA) before the thrombolytic treatment with intravenous "in bolus" infusion of 50 mg, 60 mg and 70 mg of rt-PA. The recanalization of the IRA was assessed 90 minutes later. The real status of the IRA in the angiograms was compared with the ST segment changes between the ECGs obtained before and after the thrombolytic therapy.
Fifty six (75.6%) patients presented a significant reduction in the ST segment elevation (groups I and II). Of these, 47 possessed an opened IRA. From the 18 patients who did not show ST segment decrement (group III), 13 had an occluded IRA, and 5 an opened one. The method presented sensitivity of 90.3% and a specificity of 59.1%, positive predictive value of 83.9% and negative predictive value of 72.2%.
The ST segment is an important marker of coronary recanalization or not following intravenous thrombolytic therapy.
评估急性心肌梗死（MI）患者接受静脉溶栓治疗时，ST段在识别冠状动脉再通中的重要性。
74例MI患者，62例男性，平均年龄52.6±10岁。所有患者在静脉“推注”50mg、60mg和70mg重组组织型纤溶酶原激活剂（rt-PA）进行溶栓治疗前，均经血管造影证实梗死相关动脉（IRA）闭塞。90分钟后评估IRA的再通情况。将血管造影中IRA的实际情况与溶栓治疗前后获得的心电图之间的ST段变化进行比较。
56例（75.6%）患者ST段抬高显著降低（I组和II组）。其中，47例IRA开通。在18例未出现ST段下降的患者（III组）中，13例IRA闭塞，5例IRA开通。该方法的敏感性为90.3%，特异性为59.1%，阳性预测值为83.9%，阴性预测值为72.2%。
ST段是静脉溶栓治疗后冠状动脉是否再通的重要标志物。
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