急性心肌梗死ST段显著上移伴QRS终末波形改变的预后意义  

The prognostic implication of significant ST segment elevation and distortion of terminal QRS complex with acute myocardial infarction

作　　者：李俊华[1,2] 许俊堂[1,2] 肖洁 徐琳[1,2] 齐雨清[1,2] 胡大一 王桂芝[1,2] 

机构地区：[1]首都医科大学心血管疾病研究所 [2]首都医科大学附属北京红十字朝阳医院心脏中心

出　　处：《临床心电学杂志》1997年第4期150-153,共4页Journal of Clinical Electrocardiology

摘　　要：目的：通过分析急性心肌梗死患者入院１２导心电图梗死相关导联ＳＴ段上移程度及ＱＲＳ波终末变形，预测心肌梗死患者早期预后。方法：接受溶栓治疗的连续１０３例病人，根据入院时１２导心电图ＳＴ段上移程度及有无ＱＲＳ波终末变形将病人分为两组，变形组３５人，无变形组６８人。结果：变形组肌酸激酶（ＣＫ）、ＣＫ－ＭＢ峰值明显高于无变形组，差异有显著性（Ｐ＜００５）；变形组在入院时心功能Ｋｉｌｉｐ≥Ⅲ级的发生率、住院心律失常发生率、住院病死率明显高于无变形组（Ｐ＜００５）。结论：入院１２导心电图梗死相关导联ＳＴ段显著上移及ＱＲＳ波终末变形，与早期预后有密切关系，这种评估方法有一定的临床实用价值。Objective:A novel method was introduced by assessing the magnitude of ST segment elevation and terminal QRS distortion in infarct-related leads on the admission electrocardiogram(ECG) to predict the early prognosis in patients with acute myocardial infarction(AMI) treated with thrombolytic therapy.Methods:Patients were divided into two groups based on the absence (68 cases) or presence (35 cases)of significant ST segment elevation and distortion in terminal portion of QRS complex on admission ECG. Results:The peak levels of CK and CK-MB were higher in group with QRS distortion than that without distortion(P<0 05),so were the incidence of arrhythmia,hospital mortality and ratio of cardiac function over Killip class Ⅲ on admission.Conclusion:significant ST segment elevation and distortion of terminal QRS complex on the admission ECG may predispose to the early prognosis in patients with acute myocardial infarction.This ECG method is recommended as a feasible and useful tool for scrutinizing factors related to early morbidity and mortality.

关 键 词：心电描记 预后 心肌梗塞 ST段 QRS波 

分 类 号：R542.22[医药卫生—心血管疾病]