急性ST段抬高型与非ST段抬高型心肌梗死患者心室晚电位临床特点分析  

Clinical feature analysis of ventricular late potential between acute STEMI and NSTEMI patients

作　　者：王军[1] 隋欣桐[1] 孙英贤[1] 李阳[1] 杨光[1] 徐峰[1] 张月兰[1] 徐文东[1] 李淑芬[1] 张镇钟[1] 

机构地区：[1]中国医科大学附属第一医院心血管内科,沈阳110001

出　　处：《中国综合临床》2013年第1期42-44,共3页Clinical Medicine of China

摘　　要：目的探讨心室晚电位（VLP）在急性sT段抬高型心肌梗死（STEMI）与急性非ST段抬高型心肌梗死（NSTEMI）患者中阳性发生率的差别。方法对我院心血管内科2011年1-7月收治的急性心肌梗死患者376例（其中STEMI组304例及NSTEMI组72例患者）进行VLP检测。结果STEMI组VLP阳性率为53．6％（163／304），NSTEMI组VLP阳性率为38．9％（28／72），两组比较差异有统计学意义（X^2=5．053，P〈0．05）。VLP阳性患者恶性心律失常（心室颤动、室性心动过速）发生率为14．1％（27／191），VLP阴性患者恶性心律失常发生率为7．0％（13／185），两者比较差异有统计学意义（X^2=4．996，P〈0．05）。VLP阳性是发生恶性心律失常的危险因素（OR=2．178，95％CI为1．087-4．366，P〈0．05）。结论STEMI组VLP阳性率明显高于NSTEMI组。VLP阳性患者恶性心律失常发生率明显高于VLP阴性患者。VLP是预测急性心肌梗死患者恶性室性心律失常的重要指标。Objective To discuss the positive incidence of ventricular late potential （VLP） between acute ST-segment elevation myocardial infarction （STEMI） and acute non ST-segment elevation myocardial infarction（NSTEMI） patients. Methods Three hundreds and seventy-six cases with acute myocardial infarction （304 cases with STEMI and 72 cases with NSTEMI） ,who were admitted to our hospital from Jan. to Jul. 2011, underwent VLP examination. Results The VLP positive incidence of STEMI group was 53.6% （ 163/304 ）, while that of NSTEMI group was 38.9% （ 28/72 ）, and the difference was significant （ X^2= 5.053, P 〈 0. 05 ） . The occurrence rate of malignant ventricular arrhythmia in VLP positive patients was 14. 1% （27/191 ）, while in VLP negative patients was 7. 0% （ 13/185 ） , and the difference was significant （ X^2 = 4. 996, P 〈 0. 05 ）. VLP positive was a risk factor for malignant ventricular arrhythmia （ OR = 2. 178, 95% CI： 1. 087 - 4. 366 ） . Conclusion The VLP positive rate of STEMI group is higher than that of NSTEMI group. The occurrence rate of malignant ventricular arrhythmia in VLP positive patients is higher than that in VLP negative patients. VLP is one of the important indicators to predict the malignant ventricular arrhythmia attack in acute myocardial infarction patients.

关 键 词：心室晚电位 急性ST段抬高型心肌梗死 急性非ST段抬高型心肌梗死 恶性室 性心律失常 

分 类 号：R542.22[医药卫生—心血管疾病]