Acasa Universitate Reviste Craiova Medicala Arhiva 2006 Vol 8 Nr 1, 2006 Evaluare prin sistemul MIDA a fibrinolizei cu rete
LEGATURI

Evaluare prin sistemul MIDA a fibrinolizei cu reteplază în infarctul miocardic acut

PETCU P. D.*, MILITARU C.**

REZUMAT

22 pacienti, 16 barbati si 6 femei cu varsta cuprinsa intre 33-70 ani, cu diagnosticul de IMA, internati in primele 6 ore de la debut, au fost tratati cu Rapilysine 10 unitati in bolus la interval de 30 minute. Prin sistemul H. P. MIDA au fost evident criterii de reperfuzie miocardica la 68% din pacientii cuprinsi in studiu.

Aceste criterii de reperfuzie au fost: scaderea amplitudinii vectorului ST-VM cu mai mult de 50% din valoarea initiala dupa administrarea dozei de Rapilysine si scaderea vectorului QRS-VD sub 15μV/sec. Modificarile acestor vectori (ST-VM, QRS-VD) au fost corelate cu datele clinice si fractia de ejectie a ventriculului stâng.

Coeficientii de corelatie Pearson au fost folositi pentru corelarea datelor clinice, echocardiografice si cele oferite de sistemul de inregistrare electrocardiografica HP MIDA. 18% din pacienti au fost diagnosticaţi cu angina pectorala precoce dupa fibrinoliza si 0,9% din pacienti cu reinfarctizare miocardică in primele 24 h. La 13,1% din pacienti nu s-au constatat prin sistemul HP MIDA modificari semnificative ale vectorilor ST-VM si QRS-VD.

CUVINTE CHEIE
MIDA, ischemie acută miocardică, reteplază, vector, infarct miocardic acut


MIDA system evaluation of thrombolysis using Reteplase in acute myocardial infarction (AMI)

SUMMARY
22 patients (16 men and 6 women), aged 33-70 years, with the diagnosis of acute myocardial infarction (AMI) admitted within 6 hours from the onset, were treated with 10u bolus Rapilysine, repeated after 30 min. By means of the H.P MIDA system, the criteria of myocardial reperfusion were manifest in 68% of the patients under investigation.

These criteria of reperfusion were: loss of amplitude of ST-VM vector by more than 50% of the initial value following administration of Rapilysine and the decrease under 15μV/sec of QRS-VD vector. The variations of these vectors (ST-VM, QRS-VD) were correlated with the clinical data and the ejection fraction of the left ventricle.

The Perasin coefficients for correlation were used for correlating clinical data, echographic data and those supplied by the HP MIDA electrocardiographic recording system. 18% of patients were diagnosed with early angina pectoris after thrombolysis and 0.9% of patients were diagnosed with coronary reocclusion within the first 24 hours. In 13.1% of patients, significant variations of ST-VM and QRS-VD vectors weren’t found using the HP MIDA system.


KEYWORDS: MIDA, acute myocardial ischemia, Reteplase, AMI