急性心肌梗死极早期心电图不典型变化的分析

Analysis on atypical changes in the early stage of acute myocardial infarction

目的分析急性心肌梗死（AMI）极早期心电图不典型变化,探讨其在AMI早期诊断中的意义。方法回顾性分析明确诊断为AMI患者85例心电图不典型改变的临床特点。结合患者入院后冠脉造影结果比较心电图阳性率在不同冠脉罪犯血管与非病变组间的差别。按记录心电图时的胸痛时间（Chest Pain,CP）分为3个组,对各组的阳性率进行统计分析与比较。结果 AMI患者心电图发生改变与性别、年龄、高血压、糖尿病、左室射血分数等心肌梗死的相关因素比较,差异无统计学意义（P〉0.05）,心电图改变在不同冠脉罪犯血管与非病变组间比较,差异有统计学意义（P〈0.05）,以胸痛时间分组心电图检出率比较,

Objective To analyze the features of atypical electrocardiogram changes of the early stage of acute myocardial infarction（ AMI） and to explore its significance in the early diagnosis of AMI. Methods A retrospective analysis was conduct on the clinical characteristics of atypical changes in electrocardiogram of 85 patients with AMI. Combined the result of coronary angiography, to compare the difference of the electrocardiogram positive rate in different coronary culprit vessels and non pathological changes. According to the time recording electrocardiogram Chest Pain（ CP）,they were divided into three groups,and positive rate of change of each group were statistically analyzed and compared. Results Electrocardiogram changes of patients have nothing to do with gender,age,hypertension,diabetes,myocardial infarction,left ventricular ejection fraction and the related factors（ P〈 0. 05）. The difference of electrocardiogram changes in different coronary culprit vessels and non lesion group,was statistically significant（ P〈 0. 05）. The highest detection rate of electrocardiogram changes was during the time 2 to 4 hours after chest pain occurred. Conclusions Early electrocardiogram changes of AMI mainly occur during the time 2 to 4 hours after chest pain,and peaked T wave and ischemic J wave were the main changes. Recognition of characteristics of electrocardiogram changes of AMI is helpful for the early diagnosis of AMI.