急性心肌梗死患者心肌复极异常心电图表现及其与恶性心律失常的关系研究  

Abnormal Electrocardiogram Presentations of Myocardial Repolarization and Its Relation to Malignant Arrhythmia in Patients with Acute Myocardial Infarction

作　　者：卢小伟[1] 刘亚东[1] LU Xiaowei;LIU Yadong(Department of Electrocardiogram Room,Dongfeng General Hospital Affiliated to Hubei Medical College,Shiyan 442000,China)

机构地区：[1]湖北医药学院附属东风总医院心电图室

出　　处：《实用心脑肺血管病杂志》2019年第8期41-45,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：背景恶性心律失常可导致急性心肌梗死患者出现晕厥或猝死,因此探讨急性心肌梗死患者心肌复极异常心电图表现与恶性心律失常的关系具有重要意义。目的分析急性心肌梗死患者心肌复极异常心电图表现及其与恶性心律失常的关系。方法选取2016年10月—2018年9月湖北医药学院附属东风总医院收治的急性心肌梗死患者105例,根据恶性心律失常发生情况分为A组(发生恶性心律失常,n=41)和B组(未发生恶性心律失常,n=64)。分析所有患者心肌复极异常心电图表现及恶性心律失常发生情况,比较两组患者心肌复极异常心电图表现;急性心肌梗死患者心肌复极异常心电图表现与恶性心律失常的关系分析采用多因素Logistic回归分析。结果(1)105例急性心肌梗死患者中出现ST段异常94例(89.5%),T波异常91例(86.7%),QT间期离散度(QTd)为(74.57±10.69)ms,校正的QT间期离散度(QTcd)为(84.63±12.79)ms,Tp-Te间期为(114.46±22.57)ms。(2)105例急性心肌梗死患者中发生恶性心律失常41例(39.0%),其中快速心室扑动/心室颤动10例,持续性室性心动过速10例、尖端扭转型室性心动过速5例、严重三度房室传导阻滞4例、单形性室性心动过速3例、多形性室性心动过速2例、其他7例。(3)A组患者中ST段异常、T波异常、QTd>70ms、QTcd>80ms、Tp-Te间期≥100 ms者所占比例高于B组(P<0.05)。(4)多因素Logistic回归分析结果显示,ST段异常、T波异常、QTd>70ms、QTcd>80ms、Tp-Te间期≥100 ms是急性心肌梗死患者恶性心律失常的危险因素(P<0.05)。结论急性心肌梗死患者心肌复极异常心电图表现主要包括ST段异常、T波异常、QT间期延长及Tp-Te间期延长,恶性心律失常发生率为39.0%;ST段异常、T波异常、QTd>70 ms、QTcd>80 ms、Tp-Te间期≥100 ms是急性心肌梗死患者恶性心律失常的危险因素。Background Malignant arrhythmia may cause syncope or sudden death in patients with acute myocardial infarction,thus it is of great significance to investigate the relationship between abnormal electrocardiogram presentations of myocardial repolarization and malignant arrhythmia in patients with acute myocardial infarction.Objective To investigate abnormal electrocardiogram presentations of myocardial repolarization and its relation to malignant arrhythmia in patients with acute myocardial infarction.Methods A total of 105 patients with acute myocardial infarction were selected in Dongfeng General Hospital Affiliated to Hubei Medical College from October 2016 to September 2018,and they were divided into A group(complicated with malignant arrhythmia,n=41)and B group(did not complicate with malignant arrhythmia,n=64)according to the incidence of malignant arrhythmia.Abnormal electrocardiogram presentations of myocardial repolarization and incidence of malignant arrhythmia were analyzed,and abnormal electrocardiogram presentations of myocardial repolarization were compared between the two groups;relationship between abnormal electrocardiogram presentations of myocardial repolarization and malignant arrhythmia in patients with acute myocardial infarction were analyzed by multivariate Logistic regression.Results(1)Of the 105 patients with acute myocardial infarction,94 cases occurred ST-segment abnormalities(89.5%),91 cases occurred T-wave abnormalities(86.7%),QTd was(74.57±10.69)ms,QTcd was(84.63±12.79)ms and Tp-Te interval was(114.46±22.57)ms.(2)A total of 41 cases(39.0%)out of the 105 patients with acute myocardial infarction occurred malignant arrhythmia,including 10 cases with rapid ventricular flutter/ventricular fibrillation,10 cases with persistent ventricular tachycardia,5 cases with torsional apical ventricular tachycardia,4 cases with severe third degree atrioventricular block,3 cases with monomorphic ventricular tachycardia,2 cases with polymorphic ventricular tachycardia,and 7 cases with others.(3)Propo

关 键 词：心肌梗死 心律失常 心肌复极异常 心电图 影响因素分析 

分 类 号：R542.22[医药卫生—心血管疾病] R541.7[医药卫生—内科学]