ST_(V3)评估急性前壁心肌梗死时泵功能的探讨

Evaluating Cardiac Pump Function in Patients with Acute Myocardial Infarction by ST_(v3)

目的:寻找评估前壁或广泛前壁心肌梗死(AMI)时泵功能的无创、安全及客观方法。方法:应用12导联心电图机对64例首发前壁或广泛前壁AMI的患者,根据ST_(v3)抬高的形态分为凹陷割(Ⅰ型)、垂直型(Ⅱ型)和凸起型(Ⅲ型)3组。根据患者的临床特点,以及与Killip分级,溶栓治疗和预后的关系,分别进行3组间对比研究结果:(1)3型患者在发病年龄、性别、合并高血压、糖尿病史、∑ST、比较上均无统计学差异(P >0.05)、在梗死前发作心绞痛的比较,Ⅰ型与Ⅱ型,Ⅰ型与Ⅲ型,Ⅱ型与Ⅲ型之间均有显著性差异(均P<0.01或P<0.05 (2)Killip分级:经秩和检验Ⅰ型与Ⅲ型、Ⅱ型与Ⅲ型之间的患病率方面差别有显著性(均P<0.01),Ⅰ型与Ⅱ型之间无显著性差异(P>0.05)。(3)溶栓治疗:冠脉再通率在3组间未显示有统计学上的差异。(4)Ⅲ型者病死率多于其它两组。结论:ST_(v3)抬高的形态(三种类型)是判断前壁或广泛前壁AMI泵功能的一种客观、安全、无创和科学的方法。

Objective:To search for a noninvasive,safe and objective method to evaluate the cardiac pump function in patients with acute anterior myocardial infarction (AMI) or extensive AMI. Methods:Twelve lead electrocardiogram was recorded in 64 patients with AMI or extensive AMI at first episode. The shape of STv3 was classified into 3 groups: concave type (group Ⅰ),straight type (groupⅡ) and convex type (group Ⅲ).The relationships between them and clinical characteristics,Killip grade,thrombolytic therapy and prognosis were analyzed respectively. Results: 1. Among the 3 groups, there was no signifi-cant difference in all clinical characteristics except pre-infarctive angina pectoris,such as age,sex, ∑ST and hypertension or diabetes mellitus history (P>0.05). 2. There were significant differences among Killip grades (P<0.01 ), but there was no difference between group Ⅰ and group Ⅱ(P>0.05). 3. During thrombolytic therapy,there was no significant difference in the rate of coronary reperfusion among the 3 groups. 4. The mortality of groupⅢ was higher than that of group Ⅰor group Ⅱ.Conclusion:To study the shape of STv3 elevation is an objective,safe,noninvasive and reliable method for evaluat-ing the pump function in anterior or extensive AMI.