急性心肌梗死墓碑形ST段抬高的临床意义  

Clinical Significance of the tombstone-shaped ST segment elevation in acute myocardial infarction

作　　者：陈青萍[1] 黄宁[1] 邓梓谦[1] 张凤玲[1] 

机构地区：[1]广西医科大学第三附属医院,530031

出　　处：《临床心电学杂志》2008年第6期426-428,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨急性心肌梗死(acute myocardial infarction,AMI)墓碑形ST段抬高的临床意义。方法将86例AMI患者以ST段抬高的特征分为两组,墓碑形抬高组36例、其他形抬高组50例。观察两组的一般临床资料(年龄、有否合并糖尿病),并比较两组AMI的发生部位、PCI前心梗后心绞痛、并发症及死亡的发生率、首次CK值、各项心电指标及PCI后心肌缺血再灌注损伤的发生率。结果两组各项临床指标及心电图指标差异均有统计学意义;墓碑形ST段抬高组PCI后心肌缺血再灌注损伤的发生率亦明显高于其他形ST段抬高组。结论墓碑形ST段抬高患者梗死部位特殊而广泛、并发症多、死亡率高、易出现心肌缺血再灌注损伤,对此类患者应高度重视并积极预防心肌缺血再灌注损伤的发生。Objective To explore the clinical significance of the tombstone-shaped ST segment elevation in acute myocardial infarction（AMI）. Methods Eighty-six patients with AMI were divided into two groups according to the char- acteristics of ST segment elevation, 36 patients in the tombstone-shaped ST segment elevation group（Group A）and 50 in the ordinary ST segment elevation group （Group B）. The general clinical data in the two groups were observed and the following indices in the two groups were compared with each other, sites of AMI, postinfarction angina before percutaneous coronary intervention （PCI）, complication and mortality rates, initial values of blood ereatine kinase（CK）, various eletrocardiographic indices and rates of myocardial ischemia reperfusion injury after PCI. Results The various clinical and electrocardiographic indices were significantly different between the two groups. The rates of myocardial ischemia reperfusion injury after PCI in Group A were markedly higher than those in Group B. Conclusion The infarction sites in patients with tombstone-shaped ST segment elevation are out of the ordinary and extensive; and such patients are prone to myocardial ischemia reperfusion injury with more complications and higher mortality rates. This study indicates that it is necessary to attach great importance to the occurrence of myocardial ischemia reperfusion injury and to prevent it actively in such patients.

关 键 词：急性心肌梗死 墓碑形ST段 心肌缺血再灌注 

分 类 号：R542.22[医药卫生—心血管疾病]