早期无典型心电图改变的急性心肌梗死患者心电图及冠状动脉造影特点  

Characteristics of electrocardiogram and coronary angiography in acute myocardial infarction without typical electrocardiogram

作　　者：郑晓晖[1] 向铮[2] 刘春平[1] 杨睿[1] 杨晓红[1] 王瑞平[1] 

机构地区：[1]安阳地区医院心血管科,河南安阳455000 [2]新乡医学院三全学院,2009级河南新乡453003

出　　处：《新乡医学院学报》2013年第10期827-828,832,共3页Journal of Xinxiang Medical University

基　　金：濮阳市科技攻关项目(编号:0110448)

摘　　要：目的探讨早期无典型心电图(ECG)改变的急性心肌梗死(AMI)患者的ECG及冠状动脉造影(CAG)特点,以提高AMI的诊断率。方法选择安阳地区医院早期无典型ECG改变的AMI患者36例,分析其ECG和CAG特点。结果经确诊为AMI的36例患者的心肌酶、肌钙蛋白等心肌坏死标志物均符合AMI的动态变化,且经CAG证实。16例无病理性Q波,无ST段抬高和T波直立高耸;10例仅有非特异性ST-T改变,10例既无病理性Q波,也无ST-T改变。CAG显示30例为血管闭塞,5例为严重狭窄,1例为临界病变。结论大多数AMI患者ECG均有典型的动态演变,但也有不少患者AMI发生后ECG不出现典型改变甚至没有改变,需要临床仔细鉴别,有条件应尽早行CAG证实。Objective To explore characteristic of electrocardiogram（ECG） and coronary angiography（CAG） in acute myocardial infarction（AMI） without typical ECG in order to improve the diagnosis rate of AMI.Methods Thirty-six AMI patients without typical ECG were selected and their characteristics of ECG and CAG were analyze.Results The myocardial enzyme and troponin which were landmark for myocardial necrosis,were accorded with the dynamic change of AMI in the 36 patients who had made definite diagnoses of AMI,and were confirmd by CAG.Among them,16 patients had no pathologic Q wave,ST elevation and T wave upright;10 patients had only nonspecific ST-T change,10 patients had neither pathologic Q wave nor ST-T elevation.CAG revealed 30 cases of vascular occlusion,5 cases of severe stenosis,1 case of critical disease. Conclusion Most patients with AMI have typical ECG changes graphics,but a number of AMI patients without typical ECG changes or without ECG changes need to be carefully identified in clinical.CAG should be to carry out as soon as possible.

关 键 词：心肌梗死 不典型心电图 冠状动脉造影 

分 类 号：R542.22[医药卫生—心血管疾病]