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急性前壁心肌梗死急性期ST段抬高形态与近期预后的关系 被引量：4

Relation of the ST-segment elevation pattern in acute phase of anterior wall acute myocardial infarction to short-term prognosis
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摘要 目的研究急性前壁心肌梗死(AAMI)患者急性期心电图ST段抬高形态与近期预后的关系。方法根据入院时心电图V3导联ST段抬高的不同形态将62例首次住院的AAMI患者分为3组:A组(ST段呈弓背向下抬高)18例,B组(ST段呈斜坡状抬高)27例,C组(ST段呈弓背向上抬高)17例。测定3组患者血清磷酸肌酸激酶(CPK)峰值、左室射血分数(LEVF),记录住院4周内严重并发症(包括恶性心律失常、左心功能不全和心源性休克)的发生率以及住院4周内的死亡率。结果3组患者血清CPK峰均值分别为2014.4、4486.8和5826.9IU/L,A组CPK峰均值显著低于B组和C组(P<0.05和P<0.01),B组CPK峰均值显著低于C组(P<0.05);而3组患者LEVF分别为62.1%、48.6%和38.7%,A组LEVF显著高于B组和C组(P<0.05和P<0.01),B组LEVF显著高于C组(P<0.05)。A组住院4周内严重并发症发生率和4周内死亡率明显低于B组和C组(P<0.05),而B组和C组比较,无显著性差异(P>0.05)。结论AAMI早期V3导联ST段抬高的不同形态可以反映心肌缺血性损伤的严重程度,入院时心电图V3导联ST段呈弓背向上抬高对AAMI患者的近期预后可产生不良影响。 Objective To observetherelationof ST-segmentelevationpatternof electrocardiogram(ECG)recordedin acute phaseof anteriorwallacutemyocardialinfarction(AMI)to short-termprognosis.Methods Sixty-twopatientswithfirst anteriorwallAMI weredividedinto3groupsaccordingto ST-segmentelevationpatternin leadV 3 of a12-leadECGat admission.PatientsingroupA(n=18)werecharacterizedby concavetypeof ST-segmentelevation,groupB(n=27)by straighttypeandgroupC(n=17)by convextype.Thepeakvalueof serumcreatinephosphatekinase(CPK)andleft ventricularejectionfraction(LVEF)weremeasured.Theincidenceof seriouscomplications(includingmalignantarrhythmia,leftventriculardysfunctionandcardiogenicshock)andmortalitywithintheinitial4weeksof hospitalizationwererecorded.Results Themedianvalueof peakCPKof the3groupswas2014.4,4486.8and5826.9IU/Lrespectively,andthepeak valueof CPKingroupA wasmuchlowerthanthatingroupsB andC(P<0.05andP<0.01,respectively).LVEFmeasuredby echocardiogramwithin14d aftermyocardialinfarctionwere61.2%,48.6%and38.7%respectively,showingsignificant differencebetweengroupsA andB andbetweengroupsB andC(P<0.05)as wellas betweengroupA andC(P<0.01).The incidencesof seriouscomplicationsandmortalitywithin4weeksafterAMIingroupA weremuchlowerthanthoseingroups B andC(P<0.05),buttherewas no significantdifferencebetweengroupsB andC(P>0.05).Conclusion Theshapeof ST-segmentelevationinleadV 3 of a12-leadECGinacutephaseof anteriorwallAMImayreflecttheseverityof myocardial ischemicinjury,andconvextypeof ST-segmentelevationinleadV 3 inacutephaseoftenindicatepoorshort-termprognosis.
作者 高玉琪 李志睴 丁明学 吴宏超 李公信
机构地区 第一军医大学珠江医院心内科
出处 《第一军医大学学报》 CSCD 北大核心 2002年第2期156-158,共3页 Journal of First Military Medical University
关键词 心肌梗塞 心电描记术 预后 急性病 回顾性研究 myocardialinfarction electrocardiography prognosis acutedisease retrospectivestudies
分类号 R542.22 [医药卫生—心血管疾病]
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参考文献6

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同被引文献21

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第一军医大学学报
2002年 第2期

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