急性前壁心肌梗死患者胸前导联U波倒置的临床意义

The Implication of U Wave Inversion in Precordial Leads of Acute Anterior Myocardial Infarction.

为探讨急性心肌梗死心电图胸前导联U波倒置的临床意义 ,将急性初发前壁心肌梗死患者 5 4例 ,分为U波倒置组 (A组 ) 19例 ,无U波倒置组 (B组 ) 35例 ,分析了其对心肌梗死范围及心功能的影响。两组间血钾浓度无显著差异 (4.11± 0 .36vs 4.2 9± 0 .41mmol/L ,P >0 .0 5 )。A组心肌酶峰值均较B组显著降低 ,病理性Q波导联数、ST段抬高导联数较B组减少 (分别为 2 .1± 1.4vs 3 .5± 2 .2 ,P <0 .0 5 ;4.9± 1.1vs 6 .0± 1.4,P <0 .0 1) ,而左室射血分数高于B组 (0 .6 1± 0 .0 8vs 0 .5 2± 0 .11,P <0 .0 1)。两组前降支近端及多支病变发生率无差别 ,但A组梗死区周围有较好的侧支循环建立。结论 :急性前壁心肌梗死U波倒置的患者心肌梗死程度较轻 ,左室功能较好 ,其机制与冠状动脉病变分布无关 。

To investigate the implication of U wave inversion in precordial leads of acute myocardial infarction,the patients with first acute anterior myocardial infarction were classified into two groups according to U wave pattern:inversion group(group A, n =19)and non inversion group(group B, n =35).Infarct size and left ventricular ejection fraction were analyzed.Results:Serum potassium was idendical in both groups.Peak values of cardiac enzymes were lower in group A than in group B.The number of precordial leads with abnormal Q waves and with ST segment elevation were smaller in group A than ing roup B( 2.1 ± 1.4 vs 3.5±2.2, P<0.05; 4.9±1.1 vs 6.0±1.4, P<0.01 )respectively.Left ventricular ejection fraction was higher in group A than in group B(0.61±0.08 vs 0.52±0.11, P<0.01 ).The distribution of coronary artery lesion was no statistically different.Good collaterals were more frequent in group A than in group B.Conclusion:Patients with U wave inversion have a smaller infarct size and better preserved left ventricular function.One of the cause is good collateral.