早期急性心肌梗死患者的心电图诊断价值及ST段下降率在早期心肌再灌注中的判定价值

Diagnostic value of ECG in patients with early acute myocardial infarction and value of ST segment depression rate

目的：评价心电图在早期急性心肌梗死中的诊断价值。同时探讨ST段下降率在判定其早期心肌再灌注的可行性。方法：选择我院心内科收治的120例急性心肌梗死患者，治疗前及治疗后分别测定血清肌酸激酶心型同工酶值（ CK－MB），据其判断心肌灌注情况，同时观察ST段偏移峰值及ST段下降率。并比较分类所有患者心电图表现。结果：根据CK－MB结果，其中治疗后心肌再灌注42例、低心肌灌注13例、心肌无复流55例，。治疗前ST段偏移峰值均无明显差异，心肌再灌注组ST段下降率显著高于低心肌灌注组及心肌无复流组（P＜0．05、P＜0．01）。所有心电图中，正常26例，心电图有异常改变者94例，其中：T波改变78例、ST段改变56例、等位性Q波36例、急性损伤阻滞52例、窦速32例、窦缓26例、房室传导阻滞18例。结论：ST段下降率能够良好的反映心肌再灌注情况，能早期、准确的判定急性心肌梗死患者病情并指导治疗。

Objective：To evaluate the diagnostic value of the electrocardiogram in early acute myocardial infarction.ST segment also discussed the feasibility of determining its rate of decline in the early myocardial reperfusion.Methods：Cardiology hospital admitted 120 patients with acute myocardial infarction, heart-shaped serum creatine kinase isoenzyme values （ CK-MB） before and after treatment, respectively, according to their judgment of myocardial perfusion, while observing the ST segment ST segment offset peak and decline rates.And compare the classification of all patients ECG.Results：According to the results of CK-MB, after which 42 cases of myocar-dial reperfusion therapy, low myocardial perfusion in 13 cases, 55 cases of myocardial no-reflow.ST segment deviation before treatment had no significant difference in peak myocardial reperfusion group ST segment depression was significantly higher than the low group myo-cardial perfusion and myocardial no-reflow group （P〈0.05, P〈0.01）.All ECG, normal in 26 cases, ECG abnormalities were 94 ca-ses, of which：T wave changes in 78 cases, ST segment changes in 56 cases, and other bits of Q waves in 36 cases, 52 cases of acute in-jury block, sinus tachycardia in 32 cases, 26 cases of sinus bradycardia, atrioventricular block 18 cases.Conclusion：ST segment depres-sion could be a good reflection of the rate of myocardial reperfusion cases, to early and accurate determination of acute myocardial infarc-tion in patients with the disease and to guide treatment.