体表心电标测QRST积分分析对心肌梗塞左心室功能的关系探讨

QRST isointegral departure analysis of body surface mapping for evaluation of left ventricular function in myocardial infarction

目的探讨体表心电标测中ＱＲＳＴ积分偏差图与心肌梗塞患者左室射血分数的关系。方法利用９１导联体表心电标测方法，由１００例正常人形成正常平均积分图，１１０例心肌梗塞患者积分图与之相减，除以正常人积分值的标准差，形成偏差图。偏差指数≤－２的部位为心肌电活动丧失的部位，累及的导联数代表电活动丧失的面积大小，与超声心动图、左室造影测定的左室射血分数比较。结果心肌梗塞患者偏差图上出现与梗塞部位相关的显著负性偏差区域，累及导联数多者，心功能较差。结论体表标测ＱＲＳＴ积分图及其偏差图有助于估测心功能，并对患者远期预后作出评价。

Objective To study the relationship between QRST isointegral departure analysis of body surface mapping (BSM) and left ventricular ejection fraction (LVEF) in myocardial infarction (MI) Methods Ninetyonelead BSM was performed on 110 MI patients and 100 controls Significant departure area which reflects the loss of electromotive force due to MI was calculated; while the number of leads involved indicates the size of MI The BSM data were compared with LVEF estimated by echocardiography and left ventriculography Results Each MI patient showed a consistent pattern in isointegral departure analysis which was related to the MI location Patients with large departure area indicating large infarction zone had relatively poor left ventricular function Conclusion QRST isointegral departure map is useful and feasible for detecting the location and size of MI and is helpful for evaluating the prognosis of MI patients