急性心肌梗死并发室性心律失常及心室重构患者12导联同步心电图监测及预后分析  

12-lead synchronous electrocardiogram monitoring and prognosis analysis in patients with acute myocardial infarction complicated with ventricular arrhythmia and ventricular remodeling

作　　者：苏杭[1] 刘思丽 吴婕 SU Hang;LIU Si-li;WU Jie(Department of Electrocardiogram,Gaozhou People's Hospital,Gaozhou 525200,Guangdong,CHINA)

机构地区：[1]高州市人民医院心电图室,广东高州525200

出　　处：《海南医学》2023年第2期180-184,共5页Hainan Medical Journal

摘　　要：目的探究急性心肌梗死(AMI)并发室性心律失常及心室重构患者的12导联同步心电图检测结果及预后。方法回顾性分析2018年2月至2020年1月高州市人民医院收治的80例AMI患者的临床资料。所有患者在入院24 h内进行12导联同步心电图监测,并于入院后第2天和出院后6个月进行超声心电图检查,根据是否发生室性心律失常分为室性心律失常组49例(包括室性心动过速28例,室性早搏21例)和非室性心律失常组31例,根据是否发生心室重构分为重构组33例和非重构组47例。所有患者在入院24 h内进行12导联同步心电图监测,对其Tp-Te值、校正后Tp-Te间期(Tp-Tec)、校正的QT间期(QTc)和Tp-Te/QT水平进行测定。比较不同组间患者的Tp-Te、Tp-Tec、QTc和Tp-Te/QT水平。从出院后6个月开始对所有患者进行为期24个月的随访调查,比较不同结局患者的Tp-Te、Tp-Tec、QTc和Tp-Te/QT水平。结果室性心律失常组患者的Tp-Te、Tp-Tec和Tp-Te/QT水平分别为(137.34±23.92)ms、(128.48±21.35)ms、0.29±0.04,明显高于非室性心律失常组的(118.39±17.28)ms、(109.91±18.22)ms、0.25±0.03,差异均有统计学意义(P<0.05);室性心动过速患者的Tp-Te、Tp-Tec和Tp-Te/QT水平分别为(148.28±21.91)ms、(137.25±18.91)ms、0.31±0.05,明显高于室性早搏患者的(125.09±18.83)ms、(119.46±16.08)ms、0.27±0.03,差异均有统计学意义(P<0.05);心室重构组患者的Tp-Te、Tp-Tec和Tp-Te/QT水平分别为(153.29±24.03)ms、(134.57±20.39)ms、0.31±0.05,明显高于非心室重构组患者的(120.38±19.13)ms、(108.39±17.33)ms、0.24±0.04,差异均有统计学意义(P<0.05);80例患者中有3例为非心源性猝死,2例为心源性猝死,6例出现再次心肌梗死,7例出现心力衰竭,4例出现恶性心律失常;非心源性猝死、心源性猝死、再次心肌梗死、心力衰竭以及恶性心率失常患者的Tp-Te、Tp-Tec和Tp-Te/QT水平均明显高于非室性心律失常的患者,差异均有统�Objective To study the results and prognosis of 12-lead synchronous electrocardiogram in patients with acute myocardial infarction(AMI)complicated with ventricular arrhythmia and ventricular remodeling.Methods Eighty patients with AMI treated in Gaozhou People's Hospital from February 2018 to January 2020 were selected as the research objects.All patients underwent 12-lead synchronous ECG monitoring within 24 hours of admission and ultrasonic ECG examination on the 2nd day after admission and at 6 months after discharge.According to whether ventricular arrhythmia occurred,they were divided into ventricular arrhythmia group(49 cases,including 28 cases of ventricular tachycardia and 21 cases of ventricular premature beats)and non-ventricular arrhythmia group(31 cases).According to whether ventricular remodeling occurred,33 cases were enrolled as remodeling group and 47 cases were inclued in the non-remodeling group.All patients underwent 12-lead synchronous ECG monitoring within 24 hours of admission,and their T peak-T end interval(Tp-Te)value,corrected Tp-Te interval(Tp-Tec),corrected QT interval(QTc),the ratio of Tp-Te to QT interval(Tp-Te/QT)were measured and compared among different groups.All patients were followed up for 24 months from 6 months after discharge,and the levels of Tp-Te,Tp-Tec,QTc,and Tp-Te/QT levels were compared among patients with different prognosis.Results The levels of Tp-Te,Tp-Tec,and Tp-Te/QT levels in ventricular arrhythmia group were(137.34±23.92)ms,(128.48±21.35)ms,0.29±0.04,which were significantly higher than(118.39±17.28)ms,(109.91±18.22)ms,0.25±0.03 in non-ventricular arrhythmia group(P<0.05).The levels of Tp-Te,Tp-Tec,and Tp-Te/QT in patients with ventricular tachycardia were(148.28±21.91)ms,(137.25±18.91)ms,0.31±0.05,which were significantly higher than(125.09±18.83)ms,(119.46±16.08)ms,0.27±0.03 in patients with ventricular premature beat(P<0.05).The levels of Tp-Te,Tp-Tec,and Tp-Te/QT in patients with ventricular remodeling were(153.29±24.03)ms,(134.57±20.39)ms,0.

关 键 词：急性心肌梗死 T波峰末-间期 心电图 室性心律失常 心室重构 预后 

分 类 号：R542.22[医药卫生—心血管疾病]