急性心肌梗塞患者远隔导联ST段压低的预后意义

Prognostic significance of ST-segment depression of distant leads in patients with acute myocardial infarction

分析１１５例急性心肌梗塞患者远隔导联ＳＴ段变化，其中死亡组６２例，存活组８３例。在死亡组，远隔导联ＳＴ段压低发生率为３８．８８％，压低持续时间１２～２４ｈ，压低／抬高比值＞１．０；存活组ＳＴ段压低发生率为１２．０５％，ＳＴ段压低呈一过性，压低／抬高比值气≤１．０；两者有非常显著差异（Ｐ＜０．０１）。伴有远隔导联ＳＴ段压低患者发生严重并发症如心力衰竭、心原性休克和恶性心律失常明显多于不伴有ＳＴ段压低者，其中４例伴有胸前导联ＳＴ段持续压低的急性下壁心肌梗塞患者发生了急性前壁心肌梗塞。结果提示：急性心肌梗塞患者伴有远隔导联ＳＴ段压低者可能预后不良。

The changes of ST-segment of distant leadswere analyzed in 145 patients with acute myocardialinfarction(AMI),in whom 62 died and 83survived,In the death group,incidence of ST-seg-ment depression of the distant leads was 38. 88%,du-ration of the depression was more than 24 hours,de-pression/elevation ratio>1.0; whereas in the sur-vival group,the above mentioned items were12.05%,transient and≤ 1.0,respectively.There was asignificant difference between the two groups(P<0.01).The serious complications such as heartbilure,cardiac shock and malignant arhythmia inpatients with ST-segment depression of the distantleads were more common than those in patuebts without ST-segment depression.4 patients with acuteinferior myocardial infarction manifested by theST-segment depression of chest leads developedacute anterior myocardial infarction.These resutssuggest that prognoses may be poor in patientswith acute myocardial infarction with ST-segmentdepression of distant leads.