缺血性J波者的流行病学及J波预测急性心肌梗死预后的临床价值

The epidemiology of J waves and the the value of J-wave in predicting acute myocardial infarction

目的分析J波与心肌梗死预后的关系，探讨缺血性J波者的流行病学及其J波预测急性心肌梗死预后的临床价值。方法将120例急性心肌梗死患者根据心电图是否存在J波分为观察组与对照组各60例，两组患者首先均采用常规12导联心电图（ECG）检测，再采用动态心电记录器和十二导联动态心电图仪进行24小时动态监测。结果在流行病学上，两组患者的性别、年龄、舒张压比较，差异均无显著性（P〉0．05），两组患者的收缩压以及多血管病变率比较，差异有显著性（P〈0．05）。两组患者心肌梗死事件差异总体比较差异无显著性（P〉0．05），但是个别项目差异有显著性。J波呈顿挫型、振幅高、持续时间长者提示发生心脏事件危险性增加。同时J波振幅高，持续时间长，预示发生急性心肌梗死的危险性大。结论心肌梗死合并J波综合征可能出现在心肌梗死的急性期，心电图中对J波综合征的诊断可以早期发现高危人群，提高对心源性猝死的防范。

Objective To analyze the relation between J-wave and acute myocardial infarction, and to investigate the epidemiology of J waves and the the value of J-wave in predicting acute myocardial infarction. Methods 120 patients with acute myocardial infarction according to electrocardiographic J wave of the existence were randomly divided into the observation group and the control group, conventional 12-lead electrocardiogram were used for diagnosis, holter recorder and second lead instrument to 24 h holter monitoring then were used for diagnosis also. Results In epidemiology, no significant difference in gender, age, diastolic blood pressure in two groups （P 〉 0.05 ）, but the incidence of multi-vessel disease and systolic blood pressure had significant difference in two groups（ P 〈 0. 05 ）. The incidence of arrhythmia in two grpups had no significant difference （ P 〉 0.05 ） , but some individual projects had significant difference （ P 〈 0.05 ）. J wave was frustrated type, high amplitude, duration, the elderly prompted an increased risk of cardiac events. At the same time ,with the J wave were high amplitude and long duration, risk of acute myocardial infarction were larger. Conclusion Myocardial infarction n and J wave syndrome may occur in acute myocardial infarction, and ECG can be used for early diagnosis of the J wave syndrome in high-risk groups to prevention of sudden cardiac death.