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ECG T wave and QT dispersion in acute myocardial infarction to determine the significance of efficacy of intravenous thrombolysis


Operation of technically complex and expensive equipment, not yet universal primary hospitals in China, currently the drug of choice is still the majority of AMI patients with thrombolytic reperfusion therapy. The efficacy of thrombolytic therapy has been confirmed by large-scale clinical trials, and easy to spread. Irrespective of whether what thrombolytic agent, administered by what method, the patency rate 90 minutes after administration up to 85%. This group of intravenous thrombolytic therapy with urokinase, coronary reperfusion rate of 51.8%, slightly lower compared with the literature may be related to the relatively small number of cases and ECG evaluation differences. 3.2T wave inversion after thrombolytic therapy for AMI evaluated the value of coronary reperfusion after thrombolysis in AMI ECG sT segment changes has been widespread concern and is considered an important indicator of coronary reperfusion in one ..., but the T wave changes have been rarely noticed. In fact, AMI, and the T wave inversion after thrombolytic therapy of early infarct-related coronary artery patency blood supply, is rescued myocardial performance. Of patients with AMI after thrombolysis explore the early ECG T wave inversion and the link between coronary reperfusion and confirmed by coronary angiography predict the early T wave inversion after thrombolytic therapy of coronary reperfusion and ST segment changes as a reperfusion Comparison of individual standards, the former has a higher sensitivity,[link widoczny dla zalogowanych], specificity and diagnostic value. This group within 24 hours after thrombolysis, T wave inversion were 62.7% rate of coronary reperfusion, the same as reported in the literature,[link widoczny dla zalogowanych], indicating that T-wave inversion after thrombolytic therapy is a sensitive marker of coronary reperfusion. 3.3QTd the evaluation of coronary reperfusion after thrombolysis in AMI value of myocardial ischemia, myocardial injury can lead to heart muscle is not synchronized depolarization and slow conduction, etc., causing QTd prolongation of cardiac vulnerability to prolonged,[link widoczny dla zalogowanych], sustained ventricular arrhythmia disorders and increase the likelihood of premature depolarization, but also to reduce the ventricular fibrillation threshold, leading to cardiovascular events. Myocardial ischemia after successful thrombolysis can be improved,[link widoczny dla zalogowanych], so that the heterogeneity of ventricular repolarization decreased, QTd reduced accordingly. Successful thrombolysis in this group Group 3 days,[link widoczny dla zalogowanych], 7 days QTd was significantly shorter than the failure group (P <0.01), and also significantly reduced compared with before thrombolytic therapy (P <0.01), while the failure group QTd before and after thrombolysis no significant change, the results of Zhang Yan, etc. and is the same, so we believe that shorter QTd thrombolytic reperfusion as one of the indicators. Successful thrombolytic therapy in this group after group 2 hours QTd increased, presumably due to myocardial reperfusion injury, changes of cardiac electrophysiology, leading to some repolarization inhomogeneity and dispersion of repolarization extended. Generally believed that oxygen free radicals and calcium disorders related to oxygen free radical induced membrane peroxidation of unsaturated fatty acids change the serosal and myocardial fiber myocardial ion transport protein activity, increased calcium balance disorder caused by intracellular calcium overload, delayed recovery pole. This study suggests, AMI thrombolytic therapy can reduce cardiovascular events, 24 hours after thrombolysis ECG T wave inversion and 3 to 7 days after thrombolysis, reduced QTd could be used as AMI important indicator of efficacy of intravenous thrombolysis.