梗死相关动脉通畅情况对初始ST段抬高与最终梗死面积之间关系的影响。
Influence of infarct artery patency on the relation between initial ST segment elevation and final infarct size.
作者信息
Hackworthy R A, Vogel M B, Harris P J
出版信息
Br Heart J. 1986 Sep;56(3):222-5. doi: 10.1136/hrt.56.3.222.
Thirty seven patients with acute myocardial infarction were studied to determine the effect of perfusion of the infarct artery on the relation between the extent of initial ST segment elevation and final electrocardiographic infarct size. The sum of the initial peak ST elevations in all leads correlated with electrocardiographic infarct size in patients with anterior infarction and total occlusion of the infarct artery without collaterals. In patients with anterior infarction and subtotal occlusion of the infarct artery and in all patients with inferior infarction, infarct size was smaller than predicted from the extent of initial ST segment elevation. Collaterals to the infarct artery were present in eight of the 10 patients with inferior infarction and total occlusion. In patients with a persistently occluded infarct artery without collaterals the final infarct size correlated with the extent of initial peak ST segment elevation. This study provides further evidence that spontaneous reperfusion by anterograde flow or via collaterals may salvage jeopardized myocardium.
对37例急性心肌梗死患者进行了研究，以确定梗死相关动脉灌注对初始ST段抬高程度与最终心电图梗死面积之间关系的影响。在前壁心肌梗死且梗死相关动脉完全闭塞且无侧支循环的患者中，所有导联初始ST段峰值抬高总和与心电图梗死面积相关。在前壁心肌梗死且梗死相关动脉次全闭塞的患者以及所有下壁心肌梗死患者中，梗死面积小于根据初始ST段抬高程度预测的面积。10例下壁心肌梗死且完全闭塞的患者中有8例存在梗死相关动脉侧支循环。在梗死相关动脉持续闭塞且无侧支循环的患者中，最终梗死面积与初始ST段峰值抬高程度相关。本研究进一步证明，通过顺行血流或经侧支循环实现的自发再灌注可能挽救濒危心肌。
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