心电图ST呈“墓碑形”改变的急性心肌梗死临床分析41例

TOMBSTONING OF ST SEGMENT IN ACUTE MYOCARDIAL INFARCTION

目的 探讨急性心肌梗死(AMI)“墓碑形”ST抬高的临床表现。方法 根据临床资料将41例心电图ST呈 “墓碑形”改变的AMI分为二组:①组病情凶险13例;②组病情较缓无险28例,随机选取心电图ST呈常态改变的 AMI 50例为对照组(③组);将3组的临床资料进行分析并做统计学处理(①、②组,①、②、③组)。结果 心力衰 竭、心源性休克、≥3个并发症及≥2 ST-Tom①、②组对比差异均有显著性。nST、ndST、Ptf-V1异常数、QT离散 度(QTd)、严重心律失常及病死率①组与②组、③组对比差异均有显著性,②、③组间差异无显著性。结论 ST呈 “墓碑形”改变的AMI存在2种临床表现。

Objective To approach the clinical manifestations of Tombstoning of ST segment in acute myocar-dial infarction (AMI). Methods On the basis of relevant clinical data, 41 patients with Tombstoning of ST segment in AMI were divided into two groups, group one and group two. Group one had 13 patients in extremely dangerous condition, while group two had 28 patients whose illness were not serious or dangerous. In addition, 50 patients were randomly selected with common changes of ST segment in AMI as control group (group three) . The clinical data of the three groups were analysed and compared with statistical methods. Results There were significant difference between group one and group two in heart failure, cardiogenic shock, >3 heart complication, and>2ST-Tom . Group one was also significantly different from group two and group three respectively in nST, ndST, PTf-V1 abnormal figure, QT dispersion (QTd), fatal arrhythmia and fatality rate. However, there was no significant difference between group two and group three. Conclusion Tombstoning of ST segment in AMI shows two clinical manifestations.