急性心肌梗死早期QRS波群终末变形对预后判断的价值

Prognostic value of terminal distortion of QRS com-plex in pre acute myocardial infarction

为探讨急性心肌梗死早期QRS波群终末变形对判断预后的价值,回顾分析67例发病12h内的急性心肌梗死患者的临床和心电图资料。结果显示:QRS波群终末变形组和不变形组在年龄、性别、糖尿病史、原发性高血压史以及心肌梗死部位等方面差异并无显著意义,但变形组患者心绞痛病史少见(27.5％对52.6％,P<0.05),平均每例ST段抬高的导联数(4.24±1.10对3.11±1.22,P<0.01)、平均每个导联ST段抬高的程度(0.45±0.07对0.36±0.09mV,P<0.01)、肌酸磷酸激酶峰值(1275.86±323.97对1107.05±278.06U/L,P<0.05)和严重并发症(65.5％对36.8％,P<0.05)等方面明显高于不变形组,死亡率也趋于升高。提示QRS波群终末变形对于急性心肌梗死的预后判断有一定的价值。

In order to investigate prognostic value of terminal distortion of QRS complex in pre-acute myocardial infarction, this study analyzed retrograssively clinical and electrocardiographs data of 67 patients who were admitted with 12hs since onset of acute myocardial infarction. Results showed that there were no significant difference in age, sex, previous history of diabetes and hypertension, and infarction sites between two groups (group Ⅰ with QRS complex terminal distortion and groupⅡ without). Compared with other group,group Ⅰ reported less likely to have previous history of (27. 5% vs. 52. 6%, P < 0. 05 ), but higher more likely in group Ⅰ than in group Ⅱ to have ST-seg-ment elevation in average number of leads (4.24 ±1. 10 vs. 3. 11±1. 22, P < 0. 01), average levels of leads (0. 45±0. 07mV vs. 0. 36 ± 0. 09mV, P < 0.01), peak CK levels (1275. 86±323. 97 U/L vs. 1107. 05±278. 06 U/L, P < 0. 05 ) and severe complications (65. 5% vs. 36. 8% , P < 0. 05 ), Its mortality had a tendency to rise. Authors concluded that method of QRS complex terminal distortion is valuable in prognostic assessment of acute myocardial infarction outcomes.