急性心肌梗死患者早期心电图改变与临床的相关研究

Relationship between clinical features and early electrocardiogram changes in patients with acute myocardial infarction

目的 探讨急性心肌梗死 (AMI)患者早期心电图 (ECG)梗死面积大小 ,ΣST↑ ,QTc离散度与左心衰竭、心源性休克、室性心律失常等并发症的关系 ,以探讨心电图对AMI的诊断价值。方法 188例AMI患者发病 4 8h内的心电图与临床心脏事件进行对比分析。结果 ①QRS积分≥ 7组并发症发生率与病死率均高于QRS积分 <7组 ,P<0 0 5 ;②死亡组 15例平均ΣST↑为 (15 4± 10 9)mm ,存活组 173例为 (10 7± 7 9)mm ,P <0 0 5 ;③室性心律失常组与无室性心律失常组Q -Tcd分别为 (71 37± 9 5 1)ms、(4 9 11± 16 2 4 )ms ,P <0 0 5。结论 早期心电图改变对AMI患者的心功能有密切关系 ,对预后的评估有一定的意义 ,可作为临床诊断的重要参考依据。

Objectives To explore the relationship between recent prognosis and early electrocardiogram(ECG) of infarction area, ∑ST↑, QTc dispersion and complications-left heart failure, cardiogenic shock, ventricular arrhythmia in patients with acute myocardial infarction(AMI); and to understand the value of ECG diagnosis for AMI. Methods ECG of 188 patients with AMI onset in 48 hrs and clinical materials were compared.Results ① Complications and mortality in the QRS integral ≥7 group was higher than in the QRS integral < 7 group; ② Average ∑ST↑in the death group (15 cases) was (15.4±10.9)mm; in the survival group (173 cases) was 10.7(±7.9)mm, P < 0.05;③ QTcd in the ventricular arrhythmia group and non-ventricular arrhythmia group were (71.37±9.51)ms and (49.11±16.24)ms, respectively, P < 0.01. Conclusions Understandings of the early changes of ECG in patients with AMI are very significant for its clinical diagnosis, treatment and prognosis.