急性心肌梗死患者的心室晚电位分析

Analysis of ventricular late potentials in patients with acute myocardial infarction

目的:评价急性心肌梗死(acute myocardial infarction,AMI)患者不同梗死部位,急性期、恢复期的心室晚电位(VLP)的临床意义。方法:采用NHE-2000型心电检测仪,对49例AMI患者进行VLP检测。结果:49例AMI患者中下壁心肌梗死26例中急性期12例,VLP阴性8例,阳性4例,无死亡病例。14例恢复期患者中VLP阳性9例,死亡3例;VLP阴性5例无死亡病例,心内膜下心梗3例恢复期均为阴性无死亡病例,广泛前壁心肌梗死6例中恢复期5例,VLP阴性2例,死亡1例。急性期1例VLP阴性死亡。急性期死亡率为4.76%(1/21),恢复期死亡率为14.28%(4/28),VLP均为阳性。49例VLP阳性率为40.81%(20/49)(P<0.05)。VLP阳性者心率失常的发生率和猝死的发病率明显高于VLP阴性者。值得注意的是下壁心梗发生率高26例占53.06%,死亡率11.53%(3/26)。结论:AMI患者VLP阳性具有重要的临床意义,应警惕恢复期VLP阳性患者的突发事件。

Objectives：To evaluate the clinical significance of ventricular late potentials（VLP） in 49 cases of acute myocardial infarction（AMI） with different parts of infarction,acute phase and recovery phase.Methods：The NHE-2000 type ECG detector was adopted to detect VLP in 49 cases of AMI.Results：Among 26 cases of inferior wall AMI,12 cases were in acute phase,8 cases were negative VLP and 4 cases of positive VLP had no death.Among 14 cases of recovery phase,9 cases were positive VLP and 3 cases died,5 cases were negative VLP without death.3 cases of subendocardial AMI were negative VLP in recovery phase without death.Among 6 cases of extensive anterior wall AMI,5 cases were in recovery phase,2 cases were negative VLP and 1 case died.1 case of acute phase was negative VLP and died.The mortality rate was 4.76%（1/21） in acute phase,14.28%（4/28） in recovery phase with positive VLP.The VLP positive rate in 49 cases was 40.81%（20/49）（P0.05）.The incidence of arrhythmia and sudden death in positive VLP was significantly higher than that in negative VLP.It was noteworthy that the high incidence of inferior wall AMI was 53.06%（26 cases） with the mortality rate of 11.53%（3/26）.Conclusion：Positive VLP in AMI patients has important clinical significance.The emergent event occurred in VLP-positive patients with recovery phase should be vigilant.