梗死前心绞痛对心室晚电位及Ptfv1的影响

Effects of preceeding angina on ventricular late potentials and ptfv1 after myocardial infarction

目的 研究急性心肌梗死（ＡＭＩ） 前心绞痛（ＰＡ） 对初次心肌梗死患者心室晚电位（ＶＬＰ） 及心电图Ｖ１ 导联Ｐ波终末电势（Ｐｔｆｖ１）的影响。方法 将１７２ 名ＡＭＩ患者分为ＰＡ组（ＡＭＩ前２４ ｈ 内发作两次或以上心绞痛者） 及无ＰＡ组，比较两组间并发症；于ＡＭＩ后２３±５ ｄ 检测ＶＬＰ及测量Ｐｔｆｖ１，并比较两组间差异。结果 ＰＡ组心衰、严重心律失常（ 室速及室颤） 及心源性病死率低（ Ｐ＜ ０－００５ 及Ｐ＜ ０－０５）；ＰＡ 组Ｐｔｆｖ１ 阳性率低（ Ｐ＜０－０５）；两组间ＶＬＰ阳性率差异无显著性（ Ｐ＞ ０－０５） 。结论 有ＰＡ者，Ｐｔｆｖ１ 阳性率低，提示心功能较好；虽然有ＰＡ者严重心律失常发生率低，但ＶＬＰ阳性率与无ＰＡ者差异无显著性。

Objective To evaluate the effects of preceeding angina (PA) on ventricular late potentials and terminal force of P wave in lead V1 (Ptfv1) on electrocardiogram (ECG) after acute myocardial infarction (AMI). Methods 172 patients of AMI were divided into PA group (at least had two onsets of angina pectoris within 24 hours before myocardial infarction) and no PA group. Complications in both groups were compared. After 23±5 days after infarction, VLP and Ptfv1 were examined and compared between the two groups. Results The incidence of heart failure, critical ventricular arrhythmia (ventricular tachycardial and fibrillation) and cardiac death were lower in PA group ( P <0.005 and P <0.05). The positive rate of Ptfv1 was lower in PA group. There was no difference in VLP between the two groups.Conclusion AMI patients with PA have lower positive rate of Ptfv1, suggesting better cardiac function. Although patients with PA have lower incidence of critica ventricular arrhythmia, there is no difference in the incidence of VLP between patients with and without PA.