急性下壁心肌梗死伴左胸前导联ST段下降的临床意义

Clinical significance of precordial ST segment depression in acute inferior myocardial infarction

目的 :探讨急性下壁心肌梗死 (AIMI)患者前壁和/或侧壁导联ST段下降的临床意义及预后。方法 :AIMI患者51例 ,男33例 ,女18例 ,年龄35～84岁 ,平均 (64±10)岁。所有病例均符合WHO急性心肌梗死的诊断标准 ,入院后3天内记录肌酸磷酸激酶(CPK)的峰值和入院后18导联心电图。依据有或无前壁和/或侧壁导联ST段下降分为ST段下降组(A组)和无ST段下降组 (B组 ) ,分析两组间冠心病危险因素、心律失常、心功能不全及CPK等指标的关系。结果 :两组的CPK峰值高低无差别(P>0.05)。比较心功能不全、总的心律失常和不良事件的发生率 ,A组均高于B组 (P<0.05)。结论 :表明AIMI入院时心电图伴有前壁和/或侧壁导联ST段下降组患者心律失常的发生率增高 ,预后差 。

Objective:To evaluate clinical significance of ST segment depression in precordial and/or lateral leads of electrocardiograms(ECGs) in acute inferior myocardial infarction(AIMI) and prognosis. Methods: ECGs of 51 patients with AIMI diagnosed by AMI criteria of WHO, male 33, female 18, 35 to 84 (64±10) years old were analyzed, CPK was measured in the first 3 days in-hospital, and patients were divided into two groups by precordial and/or lateral ST segment depression(group A) or none(group B).The difference of risk factors of coronary heart disease, arrhythmias or cardiac dysfunction and myocardial enzyme between the two groups was analyzed.Results:The peak of CPK between the two groups was not different significantly (P>0.05),the incidence of total arrhythmias or cardiac dysfunction and prognosis in group A is significantly higher than in group B(P<0.05).Conclusion: Patients with AIMI whose ECGs displayed ST segment depression in precordial and/or lateral lead had higher rate of arrhythmia and poor prognosis.