摘要
目的分析ST段抬高型急性心肌梗死合并J波的临床特征。方法对近年住院治疗的470例sT段抬高型急性心肌梗死患者进行回顾性研究，观察J波的形态、出现和消失的时间及最明显的部位，同时统计QT离散度、Tp-e、Tp—e／QT、心律失常以及住院期间病死率等。结果根据诊断标准确定92例ST段抬高型急性心肌梗死患者合并J波，发现J波形态多变，J波出现的时间为发病后（3．9±2．6）h，消失的时间为（26．5±17．9）h。与不伴J波的ST段抬高型急性心肌梗死患者相比，合并J波的患者QTd、Tp—e和Tp—e／QT明显增大（P〈0．05）；合并J波的急性心肌梗死患者室性心律失常的发生率明显升高（P〈0．05），合并J波的急性心肌梗死患者住院病死率明显高于不伴J波的急性心肌梗死患者（P〈0．05）。ST段抬高型急性下壁和／或右心室心肌梗死的J波发生率明显高于前壁心肌梗死（P〈0．05）。结论ST段抬高型急性心肌梗死合并J波多累及下壁或右心室，该类患者的QTd、Tp—e和Tp—e／QT增大，易发生室性心律失常，病死率高。
Objective To evaluate the clinical characteristics of ST elevation acute myocardial infarction（STEMI） with J wave. Methods Four hundred and seventy patients of STEMI from Jan. 2004 to Feb. 2008 were enrolled. The following characteristics were evaluate： whether or not with J wave, the shape, location of J wave, QT dispersion, Tp-e, Tp-e/QT, arrhythmia, mortality during hospitalization. Results The QTd,Tp-e and Tp-e/QT increased significantly in J wave patients （ P 〈 0.05 ）. The ventricular arrhythmia was more common and in-hospital mortality is much higher in J wave patients （ P 〈 0.05 ）. J wave appeared more frequently in inferior or right ventricle STEMI than in anterior STEMI（P 〈 0.05 ）. Conclusion STEMI with J wave usually involves the inferior or right wall of ventricle, and the QTd,Tp-e and Tp-e/QT increase significantly. The incidence of ventricular arrhythmia and the hospital mortality were higher in STEMI with J wave.
出处
《中华心律失常学杂志》
2009年第5期357-360,共4页
Chinese Journal of Cardiac Arrhythmias
基金
基金项目：国家自然科学基金资助（39670323）
