劳力型热射病患者心电图ST-T异常的临床意义  

Clinical Significance of ST-T Abnormalities in Electrocardiogram in Patients With Exertional Heat Stroke

作　　者：翟羽佳 徐超 薛霞 杨震林 娄云鹏 ZHAI Yujia;XU Chao;XUE Xia;YANG Zhenlin;LOU Yunpeng(Department of the Third Stationed Outpatient,NO.971s'Hospital of the People’s Liberation Army Navy,Qingdao Shangdong 266041,China;Military and Sports Teaching and Research Section,Qingdao Campus of Naval Aviation University,Qingdao Shandong 266041,China;Student Team 2-4,Qingdao Campus of Naval Aviation University,Qingdao Shandong 266041,China;Department of Intensive Care Unit,NO.971st Hospital of the People’s Liberation Army Navy,Qingdao Shandong 266071,China)

机构地区：[1]海军第九七一医院第三派驻门诊部,山东青岛266041 [2]海军航空大学青岛校区军事与体育教研室,山东青岛266041 [3]海军航空大学青岛校区学兵二大队四队,山东青岛266041 [4]海军第九七一医院重症医学科,山东青岛266071

出　　处：《中国卫生标准管理》2021年第12期99-101,共3页China Health Standard Management

基　　金：军队医学创新工程项目(18CXZ033)。

摘　　要：目的观察劳力型热射病(exertional heat stroke,EHS)患者心电图ST-T改变与病情严重程度和死亡之间的关系。方法回顾性分析2010年1月—2019年12月期间符合条件的EHS患者75例。观察发病24 h内患者的常规心电图ST-T异常情况。病情严重程度应用急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评估。记录患者发病30天的死亡情况。两独立样本之间的比较采用t检验或χ^(2)检验。结果75例患者中,有22例(29.3%)患者出现ST段下移和(或)T波倒置。ST-T正常组的APACHEⅡ评分为19.2±5.8,ST-T异常组的APACHEⅡ评分为24.5±7.5,两者之间存在显著统计学差异(P<0.05)。ST-T正常组发病30天的死亡率为13.2%,ST-T异常组发病30天的死亡率为36.4%,两者之间存在显著统计学差异(P<0.05)。结论ST-T异常是EHS患者常见的一种心电图改变,并且可以作为反映病情严重程度和判断预后的新指标。Objective To observe the relationship between the changes of ST-T of ECG and the severity and death of patients with exertional heat stroke(EHS).Methods 75 eligible EHS patients from January 2010 to December 2019 were retrospective analyzed.ST-T abnormalities of the patients on the routine ECG within 24 hours of onset was Observed.The severity of the disease was assessed using the Acute Physiology and Chronic Health Status Score SystemⅡ(APACHEⅡ).The death of the patient within 30 days of onset was recorded.χ^(2) test or t test was used to compare between the two independent samples.Results Of the 75 patients,22(29.3%)patients had ST segment depression and/or T wave inversion.The APACHEⅡscore of the ST-T normal group was 19.2±5.8,and the APACHEⅡscore of the ST-T abnormal group was 24.5±7.5.There was a significant statistical difference between the two groups(P<0.05).The 30-day mortality rate of ST-T normal group was 13.2%,and the 30-day mortality rate of ST-T abnormal group was36.4%.There was a significant statistical difference between the two groups(P<0.05).Conclusion ST-T abnormality is a common ECG change in EHS patients,and it can be used as a new indicator to reflect the severity of the disease and prognosis.

关 键 词：劳力型热射病 心电图 预后 严重程度 ST-T异常 急性生理学与慢性健康状况评分Ⅱ 

分 类 号：R59[医药卫生—内科学]