Monassier J P, Steg P G, Elkouby A, Hanssen M, Chalet Y, Gressin V
Hôpital du Hasenrain, service de chirurgie cardiaque, Centre hospitalier de Mulhouse, .
Arch Mal Coeur Vaiss. 1993 Jul;86 Spec No 4:79-84.
Intracoronary thrombolysis showed the chronological order of clinical electric and biological changes following the reestablishment of coronary flow. These changes make up the reperfusion syndrome; ST segment changes are part of this syndrome. They occur in practically all cases at the moment of reperfusion. The ST elevation may regress more or less rapidly or, on the contrary, increase transiently to a greater or lesser degree. When associated with other criteria of reperfusion-enzyme changes, arrhythmias, ST changes contribute to the indirect diagnosis of reestablishment of coronary flow. Rapid decrease in ST segment elevation is usually associated with a good myocardial outcome. The prognostic significance of transient increases in ST elevation--so called "reperfusion ischaemia"--is not fully understood, in particular its relationship to myocardial reperfusion injury. The myocardial prognosis after reperfusion may be the "biological" sum of cellular lesions due to ischaemia and reperfusion.
冠状动脉内溶栓显示了冠状动脉血流重建后临床电和生物学变化的时间顺序。这些变化构成了再灌注综合征；ST段改变是该综合征的一部分。它们几乎在所有再灌注时刻都会出现。ST段抬高可能或多或少迅速消退，或者相反，会暂时不同程度地进一步升高。当与再灌注的其他标准——酶变化、心律失常、ST段改变相关时，有助于间接诊断冠状动脉血流重建。ST段抬高的迅速下降通常与良好的心肌预后相关。ST段抬高的短暂增加——即所谓的“再灌注缺血”——的预后意义尚未完全明了，尤其是其与心肌再灌注损伤的关系。再灌注后的心肌预后可能是缺血和再灌注所致细胞损伤的“生物学”总和。
