35岁以下青年急性心肌梗死患者心电图特征对预后判断的意义  

Features and prognostic significance of electrocardiography in acute myocardial infarction patients younger than 35 years

作　　者：黄觊[1] 钱海燕[2] 李志忠[1] 张京梅[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京市100029 [2]中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院心血管疾病国家重点实验室冠心病诊治中心,北京市100037

出　　处：《中华实用诊断与治疗杂志》2013年第5期446-448,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81000130);国家自然科学基金(81000091);北京市卫生局青年科学研究资助项目(QN2010-010);北京新星计划(2008-B78;北京市科学技术委员会)

摘　　要：目的探讨急性心肌梗死(acute myocardial infarction,AMI)青年患者的心电图特点及其与预后的关系。方法 117例35岁以下AMI患者,依据出院后1a内是否发生主要不良心血管事件(major adverse cardiovascular events,MACE)分为有MACE组与无MACE组,比较2组临床特征、冠状动脉造影结果和入院心电图特征。结果有MACE组患者体质量指数,有吸烟史、冠心病家族史、糖尿病比例,入院时血肌酐和血红蛋白水平、左室射血分数、冠状动脉造影多支和左主干病变等各指标与无MACE组比较差异均有统计学意义(P<0.05);多元Logistic回归分析结果显示,QTc间期、侧壁导联ST段压低与出院后1a内发生MACE有明显相关性(HR=1.5,P=0.03;HR=4.7,P=0.00);对危险因素进行校正后,QTc间期和侧壁导联ST段压低仍与1a内发生MACE有明显相关性(HR=1.2,P=0.04;HR=3.6,P=0.01)。结论 QTc间期和侧壁导联ST段压低可作为35岁以下青年AMI患者出院后1a发生MACE的预测因素。Objective To evaluate the features of electrocardiography （ECG） of acute myocardial infarction （AMI） patients younger than 35 years and its relationship with prognosis. Methods A total of 117 AMI patients younger than 35 years were followed up the maior adverse cardiovascular events （MACE） in one year after being discharged, and were divided into MACE group and non-MACE group. The clinical data, coronary angiography results and ECG features at admission were compared and analyzed. Results There were significant differences in body mass index, smoking history, family history of coronary heart disease, diabetes mellitus proportion, serum creatinine, hemoglobin, left ventricular ejection fraction, multiple branches and left main lesions between MACE group and non-MACE group （P〈 0.05）. Multivariate logistic regression analysis showed corrected QT interval （HR： 1. 5, P 0.03） and lateral ST-depression （HR：4.66, P= 0.00） were obviously correlated with 1-year MACE. After adjustment for all risk variables, corrected QT interval （HR=1.2, P=0. 04） and lateral ST depression （HR=3.6, P=0.01） were correlated with 1-year MACE. Conclusion Corrected QT interval and lateral ST-depression are independent predictors of 1 year MACE in AMI patients younger than 35 years.

关 键 词：心肌梗死 青年 心电图 预后 

分 类 号：R542.22[医药卫生—心血管疾病]