心电图判断近期急性下壁心肌梗死的临床预后

Significance of electrocardiogram in early prognostic evaluation of acute inferior myocardial infarction

目的:探讨心电图对判断近期急性下壁心肌梗死临床预后的意义.方法:回顾性分析186例首次入院的急性下壁心肌梗死患者ECG及相关的临床资料,按照住院期间的近期预后分为死亡组和存活组,比较两组间的梗死部位、各种心律失常发生率、ST段抬高的最高值和QTd及J波.结果:单纯下壁梗死的发生率存活组大于死亡组(P<0.05);≥3个部位梗死的死亡组发生率多于存活组(P<0.05);死亡组和存活组的室性心律失常的发生率有统计学差异(P<0.05);死亡组和存活组房室传导阻滞的发生率差异有统计学意义(P<0.05);死亡组ST段抬高值高于存活组(P<0.05);急性下壁心肌梗死死亡组QTd值大于存活组(P<0.05),J波明显多于存活组(P<0.05).结论:心电图诊断≥3个部位的梗死、室性心律失常、房室传导阻滞、ST段抬高值、QT以及J波的有无是急性下壁心肌梗死近期死亡的预测因素,临床上可通过心电图来判断急性下壁心肌梗死患者的近期临床预后.

AIM： To investigate the significance of electrocardiogram（ECG） in early clinical prognosis of acute inferior myocardial infarction. METHODS： ECG data were analyzed retrospectively in 186 patients with first inferior AMI, which were divided into death group and living group, according to early prognosis. The analyzed data included the sites of AMI, the incidence of arrhythmia, the elevation level of ST segment, QT dispersion and J wave. RESULTS： The incidence rate of solely inferior AMI was higher in the living group than in the death groupt （ P 〈 0.05 ）, but the incidence of more than or equal to three infarction sites was lower in the living group （ P 〈 0.05 ）. There was significant difference in the incidences of ventricular arrhythmia and AVB between the 2 groups （P 〈 0.05 ）. Compared with the living group, the elevation level of ST segment, the value of QT dispersion and J wave were apparently higher in the death group （ P 〈 0.05 ）. CONCLUSION： The early prognosis of AMI patients may be judged by the ECG, including the infarction site, ventricular arrhythmia, J wave, AVB, elevation level of ST segment, and the value of QT dispersion.