摘要
在急性心肌梗死 (AMI)发病过程中 ,患者心电图 (ECG)呈现不同形态的 ST段抬高 (STE)。为探讨不同形态 STE与 AMI预后的关系。选择 AMI患者 2 39例 ,观察其 STE的变化规律及幅度 (以 TP段为基线 ,以QRS波群起点后 16 0 ms处为测量点 )。结果显示 ,就诊早者 STE多呈下弧形 ,继之呈现上斜形、上弧形的变化规律 ;就诊晚者多表现为上斜形或上弧形 STE。下弧形 STE持续时间为 2～ 8.5小时 ;上斜形持续时间为 7～ 32小时 ;上弧形持续时间均在 2 4小时以上。发病 6小时后就诊者 ,79.5 %见不到下弧形 STE,其病死率 (15 .4 % )显著高于发病 6小时内就诊者 (80 %表现为下弧形 STE,其病死率为 6 % )。心肌酶 CK峰值与 STE幅度存在显著相关性 (P均 <0 .0 1) ,但与 STE形态无关。提示 AMI时 STE形态呈下弧形 -上斜形 -上弧形的变化规律。下弧形抬高提示损伤早期 ,上斜形抬高为损伤中期 ,上弧形抬高为损伤晚期。可以根据 STE的不同形态来估计 AMI的发生时间 ,判断预后。建议以 QRS起点后 16 0～ 180 ms作为
There are different amplitudes and shapes of ST segment elevation(STE)of electrocardiogram during the progress of acute myocardial infarction(AMI) To investigate the relation between the different shapes of STE and the prognosis of AMI 127 patients with anterior AMI and 112 patients with inferior AMI were fit for entrance criteria The regulations of STE were studied The measurement of ST segment was used TP segment as baseline,the measuring point of ST segment was at 160ms after the beginning of QRS complex Results showed that the shapes of STE were based on the prolongation of ischemic time,showed the regularity of concave straight convex type The patients came to hospital earlier,having concave type,following straight and convex thpe The patients came later,mostly being straight or convex type The lasting time of concave,straight and conves types of STE were 2～8 5h,7～32h and over 24h,respectively Patients who came to hospitals over 6h after onset had not concave type of STE,whose in hospital mortality was 15 4% Otherwise,80% patients who came to hospitals within 6h after onset had concave type of STE,whose in hospital mortality was 6% There was a significant difference between the two groups The peak value of CK was associated with the amplitude of STE of same location of AMI(P<0 01),but without the shapes of STE These suggest that the different shapes of STE reflect the different phases of myocardial ischemia and injury during AMI The progress of AMI can be assessed according to the different shapes of STE The measuring point of ST segment should be at the 160 180ms after the beginning of QRS complex
出处
《山东医药》
CAS
北大核心
2002年第15期8-10,共3页
Shandong Medical Journal
