心电图诊断急性心肌梗死范围的研究  

The infarction size evaluated by electrocardiogram for acute ST-segment elevation myocardial infarction

作　　者：曹邦明[1] 刘同库[2] 王人彭[1] 骆秉铨[1] 

机构地区：[1]徐州市第三人民医院心内科,221005 [2]北华大学医学院附属医院心内科,132000

出　　处：《临床心电学杂志》2006年第6期409-411,共3页Journal of Clinical Electrocardiology

摘　　要：目的研究Wikins公式预测心肌梗死范围与QRS记分系统评估梗死范围的关系。方法129例ST段抬高型急性心肌梗死患者,42例接受延迟经皮冠脉介入治疗,21例接受紧急冠脉介入治疗,26例尿激酶静脉溶栓,40例内科药物保守治疗。以Wikins计算公式预测心肌梗死范围。分别于围手术期1周内、静脉溶栓或内科药物保守治疗1周内、2周、1月及随访期内以Nancy B.Hindman提出的54项标准32分制的QRS记分系统评估梗死范围。结果前壁心肌梗死Wikins计算公式预测心梗范围与QRS记分评估梗死范围有相关性,但延迟冠脉介入治疗组二者无相关性。下壁心肌梗死时,Wikins公式预测心肌梗死范围与各组QRS记分评估梗死范围均无相关性。结论Wikins计算公式不适合延迟冠脉介入治疗患者梗死范围评估。Wikins公式预测下壁心肌梗死不可靠,可能需进一步修订。Objective To evaluate the infarction size by Wikins＇ formula and by QRS system in acute ST- segment elevation,＇ myocardial infarction. Methods 129 patients with AMI and with ST-segment elevation, 21 patients were treated by urgent PCI, 42 patients by delayed PCI, 26 patients by intravenous thronbolytic therapy, 40 patients by medical conservative therapy. Wikins＇ formula was used to evaluate the predictive infarction size （PIS）. The 54 criteria/32 point system proposed by Nancy B.Hindman was Used to estimate the infarction size （PIS）. The maximum Was recorded during the first perioperative week and within 1 week for the thrombolytic therapy group as well as the medical conservative therapy gr6dp. Recorder was else made in 2 weeks, 1 month and in the follow-up period. Results There is linear correlation＇ between the PIS and QRS-estimated infection size for anterior myocardial infarction but no linear correlation in the delayed PCI group. There are no linear correlation between the PIS and QRS-estimated infarction size for inferior myocardial infarction in all the four groups. Conclusions Wikins＇ formula is unsuitable for delayed PCI. Wikins＇formula is not reliable for the evaluation of the inferior wall infarction size and maybe need repairing.

关 键 词：QRS记分 急性心肌梗死 梗死范围 

分 类 号：R542.22[医药卫生—心血管疾病]