差电位图诊断心肌梗死的价值

Diagnostic value of departure maps for myocardial infarction

为了探讨体表差电位图对心肌梗死 (MI)的诊断价值 ,应用 BSPM- 型体表电位标测微机系统和 KT5 0 0全体表心电分析系统 ,对 42例对照组和 42例 MI患者进行了差电位图的研究 ,并与常规心电图 (ECG)对比分析。结果表明 :前壁 MI在心室除极 10 ms时 ,左前胸上部出现差电位图偏离指数 (DI) <- 2的区域 ,持续 2 0～ 30 m s。下壁 MI在心室除极 2 0 ms时 ,前胸和后背下部均为 DI<- 2的区 ,至 QRS40～ 5 0 ms负区范围缩小或消失。且 DI异常负区与心室造影局部射血分数降低的节段相一致 ,其范围与射血分数降低的节段数有关。 DI诊断 MI的阳性率为 10 0 .0 % ,而 ECG为 81.0 % ,二者差异显著 (P<0 .0 5 )。提示 :体表差电位图 DI是检测 MI的敏感指标 ,诊断价值显著高于 ECG,且能够确定 MI的部位和范围。

To explore the diagnostic value of body surface departure maps for myocardial infarction (MI). The departure maps were researched in 42 normals and 42 patients with MI using a BSPM Ⅲ model computer system and a KT500 whole body surface electrocardiographic analysis system. The findings were also compared with electrocardiogram (ECG). The results showed that the less than 2 negative areas of departure index (DI) in patients with anterior MI were appeared in upper of left anterochest at 10 ms of ventrical depolarization and lasting about 20~30 ms; To the patients with inferior MI, the negative areas of DI were apppeared of under chest and back at 20 ms of ventrical depolarization, and these negative areas reduced or disappeared at 40~50 ms of QRS. The abnormal negative areas of DI were the same to the domains with local ejection fraction reduction in ventriculography,and we found the negative area′s size had much to do with the amount of those domains. The positive rates of DI and ECG for diagnosing MI was 100.0% and 81.0% respectivly. The difference between two methods was statistically sigificant ( P <0.05). The results suggested that DI was a sensitive index to diagnosing MI, its diagnostic value was more important than ECG and could also locate the area and the scope of MI.