摘要
目的:探讨急性ST段抬高型心肌梗死患者心电图对应导联压低对患者诊治及预后的预测价值。方法:收集我院心内科冠心病监护病房急性ST段抬高型心肌梗死患者心电图存在对应性压低的患者共102例,选取同期心电图提示相似心肌梗死部位,且临床特征具有可比性的无明显对应性压低的急性ST段抬高型心肌梗死患者102例作为对照。观察两组患者冠脉闭塞部位、左室射血分数及心肌肌钙蛋白I和NT-proBNP水平,记录患者住院期间发生的严重心肌梗死并发症和死亡事件。分析存在对应性ST段压低与无显著压低对照组患者的冠脉闭塞部位、心脏功能及临床心血管事件的差异。结果:急性ST段抬高型心肌梗死伴有对应性ST段压低的患者,其心肌梗死面积显著大于不伴有对应性压低的患者,其心脏左室功能、心肌梗死并发症及存活率均显著低于不伴对应性压低的患者。且急性ST段抬高型心肌梗死同时伴有的对应性导联压低对冠脉闭塞部位具有较好的判断作用。结论:临床上应高度重视ST段抬高型心肌梗死患者的对应性ST段压低,是评估心肌梗死患者病情和预后的重要手段。
Objective： To investigate the corresponding electrocardiogram ST-segment depression in the diagno- sis and prognosis in the acute ST-segment elevation myocardial infarction. Method： We collected 102 acute ST-seg- ment elevation myocardial infarction patients with corresponding electrocardiogram ST-segment depression from coronary intensive care unit in our hospital, and we collected 102 acute ST-segment elevation myocardial infarction patients without corresponding electrocardiogram ST-segment depression in the same period as control group. We observed the coronary occlusion site through coronary angiography, assessed the left ventricular ejection fraction, cardiac troponin I and NT-proBNP levels, and recorded the severe myocardial infarction complications and cardiac death events during hospitalization between the two groups. We analyzed the differences in the coronary artery oc- clusion site, cardiac function and clinical events between the two groups. Result：We found the infarct size in the a- cute ST-segment elevation myocardial infarction patients with corresponding ST-segment depression was signifi- cantly larger than in the patients who were not associated with depression, and the left ventrieular function, myo- cardial infarction complications and survival rates were significantly lower than in the patients without correspond- ing ST-segment depression. And the electrocardiogram corresponding ST-segment depression was a key point to determine the occluded coronary artery site. Conclusion：The electrocardiogram corresponding ST-segment depres- sion has great value in determining the condition and prognosis of myocardial infarction in the patients with acute ST-segment elevation myocardial infarction.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2015年第5期501-504,共4页
Journal of Clinical Cardiology
基金
国家自然科学基金资助(No:30871069
81470483)
关键词
急性ST段抬高型心肌梗死
对应性ST段压低
冠状动脉闭塞部位
严重心肌梗死并发症
预后
acute ST-segment elevation myocardial infarctiom corresponding ST-segment depression
site ofoccluded coronary artery~ severe myocardial infarction complications~ prognosis
