心肌梗塞的心室晚电位研究

Studies of Ventricular Late Potentials in the Patients With Myocardial Infarction

本文对50例心肌梗塞(MI)病人的心室晚电位(VLP)检测结果进行定性与定量分析:(1)MI组与正常组之间存在着显著性差异(P<0.001),提示VLP是一种病理性的电活动;(2)不同部位MI的VLP阳性检出率下壁为38％、前壁为35％、前间壁为33％、前侧壁为20％,提示下壁MIVLP的阳性检出率较高。此外,根据对VLP定量分析的结果发现,下壁、前间壁MI对反映传导和电压的指标均敏感。而前壁、前侧壁MI仅对反映传导的指标敏感,其机理需进一步探讨;(3)急性心肌梗塞与陈旧性心肌梗塞组都有形成VLP的可能,但前者检出率相对较高。由此提出应根据不同发生机制而采取针对性较强的防止电不稳定的措施;(4)MI伴室性心律失常(VA)组与不伴VA组之间存在着显著性差异(P<0.001),提示VLP阳性者VA的发生率较高。

In 50 patients with myocardial infarction (MI), the ventricular late potentials(VLP) were analysed qualitatively and quantitatively. The results suggested; 1. There were significant differences between MI group and normal group(P<0. 001). It demonstrated that positive VLP was a pathologic electrocardial activation. 2. The positive VLP in the patients with Ml of inferior, anterior, anter-oseptal, and anterolatedal wall were respectively 38%,35%,33%,and 20%. It indicated that MI of inferior wall had the greatest rist. Besides,based on the results of quantitative analysis, it is was found that MI of inferior wall were sensitive to the two indexes reflecting conduction and voltage of the VLP, while MI of anterior wall was only sensitive to the before. However, these mechanisms would be further approached. 3. VLP were formed poentially in both of acute myocardial infarction group and old myocardial infarction group but the mechanisms would be different. Therefore, it was put forward that the effective measures of preventing and treating electrocardial unstability must be taken according to the different mechanisms. 4. There were significant differences between MI with and without ventricular arrhythmia(VA)groups (P<0. 001). It showed that positive VLP correlated with VA and sudden death.