老年急性ST段抬高型心肌梗死心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ的相关性研究

Correlation between Ⅲ class ischemia and serum high sensitive troponin Ⅰ in elderly patients with acute ST segment elevation myocardial infarction

目的探讨老年急性ST段抬高型心肌梗死心电图Ⅲ级缺血与血清高敏肌钙蛋白T的相关性。方法回顾性选自于2015年6月至2017年6月期间收治的老年急性ST段抬高型心肌梗死患者91例,根据心电图分级:Ⅱ级心肌缺血组41例,Ⅲ级心肌缺血组50例。比较两组心肌梗死面积、心律失常发生情况、再梗死和病死情况、血清高敏肌钙蛋白Ⅰ水平变化,及心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ相关性。结果Ⅲ级心肌缺血组心肌梗死面积高于Ⅱ级心肌缺血组(P <0. 05);Ⅲ级心肌缺血组心律失常发生率(38. 00%)高于Ⅱ级心肌缺血组(17. 07%)(P <0. 05);Ⅲ级心肌缺血组再梗死和病死率高于Ⅱ级心肌缺血组(P <0. 05);Ⅲ级心肌缺血组血清高敏肌钙蛋白Ⅰ水平高于Ⅱ级心肌缺血组(P <0. 05);心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ呈线性正相关。结论老年急性ST段抬高型心肌梗死心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ密切相关,且心电图Ⅲ级缺血心肌梗死面积大、心律失常发生率高、再梗死和病死率高,具有重要临床研究价值。

Objective To investigate the correlation between electrocardiogram Ⅲ level ischemia and serum high sensitive troponinⅠin elderly patients with acute ST segment elevation myocardial infarction(AMI).Methods 91 cases of elderly patients with acute ST elevation myocardial infarction were selected in our hospital from June 2017 to June 2015,myocardial ischemia were classified according to the enzyme classification:41 cases in gradeⅡmyocardial ischemia group,50 cases grade Ⅲ myocardial ischemia group.The infarct size,arrhythmia,reinfarction and mortality,serum hypersensitive cardiac troponinⅠlevels,and the correlation between Ⅲ class ischemia and serum high sensitive troponin I were compared between the two groups.Results The myocardial infarction area of myocardial ischemia group was higher than that of grade Ⅱ grade Ⅲ myocardial ischemia group(P<0.05).The incidence of Ⅲ myocardial ischemia arrhythmia group(38%)was higher than that of gradeⅡmyocardial ischemia group(17.07%)(P<0.05).The reinfarction and mortality rate of Ⅲ myocardial ischemia group was higher than that of gradeⅡmyocardial ischemia group(P<0.05).The serum high sensitive troponin Ⅰ level of Ⅲ myocardial ischemia group was higher than that of the Ⅱ level of myocardial ischemia group(P<0.05).Grade Ⅲ ischemia and serum high sensitive troponin I were linearly related.Conclusion The ECG Ⅲ ischemia in elderly patients with acute ST segment elevation myocardial infarction is positively related to serum high sensitive troponin I.And the level of myocardial infarction of myocardial Ⅲ is high,the incidence of arrhythmia is high,reinfarction and mortality are high,which has important clinical research value.