心肌梗死后Q波导联ST段持续抬高的临床意义  

ST-segment elevation on Q leads and prognosis after infarction

作　　者：郑宏超[1] 徐惠芬[1] 吕宝经[1] 朱向阳[1] 

机构地区：[1]上海第二医科大学附属新华医院心内科,上海200092

出　　处：《临床心血管病杂志》2001年第6期257-258,共2页Journal of Clinical Cardiology

摘　　要：目的 :探讨心肌梗死 ( MI)后 Q波导联 ST段持续抬高的临床意义。方法 :选取 MI后 Q波导联 ST段持续抬高 (静息心电图 )的患者 3 0例 ( ST段抬高组 ) ,以无 ST段持续抬高的 MI患者 2 6例为对照组 ,两组均行冠状动脉 (冠脉 )造影及左心室造影 ,观察两组病例的左室收缩末期容积 ( ESV)、左室舒张末期容积 ( EDV)、射血分数 ( EF)、局部室壁运动情况及冠脉阻塞部位、程度。结果 :ST段抬高组较对照组 EF减低 ( P <0 .0 1)、ESV增大 ( P <0 .0 5 ) ,冠脉完全闭塞、局部室壁无收缩或矛盾运动比例 ST段抬高组明显高于对照组 ( P <0 .0 5 ) ,而两组 EDV、室壁瘤发生比例差异无显著性意义 ( P >0 .0 5 )。结论 :MI后 Q波导联 ST段持续抬高与冠脉完全的闭塞、大面积的梗死、EF的显著降低、ESV的明显扩大直接相关 ;与室壁瘤、EDV无显著相关 ,是一种简便、无创的临床检测手段 ,对 MI后患者的治疗和预后提供积极的帮助。Objective:To evaluate the clinical significance and prognosis in patients with ST segment elevation on Q leads after infarction.Method:The study group was divided according to the existence(n=30) or no existence (n=26)of resting ST segment elevation.Cardiac catheterization were performed in all patients.Left ventricular end systolic volumes (ESV), end diastolic volumes(EDV), ejection fraction(EF), regional wall motion, and percentage of coronary occlusion were analyzed.Result:There were significant differences between patients with and those without ST segment elevation in EF (P< 0.01 ), ESV (P< 0.05 ). There were a higher probability of occlusion and more severe regional dysfunction in patients with ST segment elevation after infarction (P< 0.05 ). There were no significant differences between two groups in EDV and the chance of aneurysm (P> 0.05 ).Conclusion:ST segment elevation on Q leads after infarction is directly related to a higher prevalence of total occlusion, a larger infarct, lower EF, greater ESV, but not related to ventricular aneurysm and EDV.This electrocardiographic sign could provide noninvasive, simple information for the treatment and prognosis of patients after infarction.

关 键 词：心肌梗死 心肌电描记术 Q波导联 ST段持续抬高 

分 类 号：R542.22[医药卫生—心血管疾病] R540.41[医药卫生—内科学]