ST段抬高型急性心肌梗死出现J波综合征的临床特点分析

Clinical characteristics of patients with ST segment elevated acute myocardial infarction and J wave syndrome

目的分析ST段抬高型急性心肌梗死出现J波综合征的临床特点。方法回顾性分析该院470例ST段抬高型急性心肌梗死患者的临床资料,观察心电图J波型态、测定Q-T离散度、心律失常类型及死亡患者人数等,应用SPSS11.5统计软件进行统计分析。结果J波综合征在急性下壁心肌梗死的发生率14.68%,在前壁心肌梗死发生率4.89%(P<0.05);不同性别间差异无显著性(男性25%,女性21.2%),(P>0.05);J波综合征患者Q-T离散度(51±25)ms,不伴J波综合征(46±23)ms,(P<0.05);其中J波综合征死亡者Q-T离散度(81±22)ms,存活者(46±22)ms,(P<0.05);J波综合征的患者恶性心律失常发生率40.2%,死亡率18.48%,不伴J波综合征的患者分别是29.1%和9.79%(P<0.05)。结论ST段抬高型急性心肌梗死出现J波综合征多累及下壁,患者的Q-T离散度增大,易发生室性心律失常,死亡率高。

[Objective] To understand the clinical characteristics of patients With ST segment elevated acute myocardial infarction and J wave syndrome. [Methods] Clinical data including the changelof ECG in J wave syndrome, the QT dispersion, the type of arrhythmia and died of 470 patients with ST segment elevated acute myocardial infarction was observed. [Results] The incidence of J wave syndrome in patients with inferior myocardial infarction was higher than with anterior myocardial infarction （χ^2=31.329, P 〈0.05）. The QT dispersion of J wave syndrome in ST elevated segment acute myocardial infarction was longer than others without J wave syndrome （P 〈0.05）. The QT dispersion of died patients with J wave syndrome was longer than the living patients （P 〈0.05）. The occurrence （χ^2=4.03, P 〈0.05） and mortality （χ^2=7.13, P 〈0.05） of ventricular arrhythmia in the patients with J wave syndrome were higher than the patients without J wave syndrome. [Conclusion] J wave syndrome is a common appearance in the patients with ST segment elevated acute inferior myocardial infarction. They have long QT dispersion as well as high occurrence and mortality of ventricular arrhythmia in these patients with J wave syndrome.