急性前间壁心肌梗死患者心电图T波变化与左室射血分数关系探究  

Exploring the relationship between electrocardiographic T-wave changes and LVEF in patients with acute anterior interstitial myocardial infarction

作　　者：孙涌莉 杨登云[2] 邢明旭 Sun Yongli;Yang Dengyun;Xing Mingxu(ECG Room,the Third People′s Hospital of Anyang,Anyang 455000,China;不详)

机构地区：[1]河南省安阳市第三人民医院(安阳市心血管病医院)心电图室,455000 [2]河南省安阳市第三人民医院(安阳市心血管病医院)心内科,455000 [3]河南省安阳市第三人民医院(安阳市心血管病医院)肾内科,455000

出　　处：《实用医学影像杂志》2023年第6期435-438,共4页Journal of Practical Medical Imaging

摘　　要：目的探究急性前间壁心肌梗死患者心电图T波变化与左室射血分数(LVEF)的关系,为心肌梗死诊治提供新依据。方法选择2020年3月至2023年4月期间我院收治的急性前间壁心肌梗死患者80例作为研究对象,依据心电图T波检查结果分为倒置组(38例)与直立组(42例)。依据早期最大倒置T波(NTmax)水平倒置组患者分组,将NTmax≥10 mm、4~10 mm、<4 mm患者分别作为深倒置T波组(11例)、中度倒置T波组(14例)、浅倒置T波组(13例)。对比直立组与倒置组患者心功能指标,统计对比直立组不同T波恢复直立时间患者LVEF水平,统计不同NTmax水平倒置组患者LVEF水平,采用Peason分析NTmax与LVEF水平。结果倒置组患者LVEF低于直立组,左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)显著高于直立组,差异有统计学意义(P<0.05),2组患者左心室峰值充盈时间(LVTPFRv)对比差异无统计学意义(P>0.05)。直立组患者不同T波恢复直立时间患者LVEF水平对比差异有统计学意义(P<0.05)。不同NTmax水平倒置组患者LVEF水平对比差异有统计学意义(P<0.05)。相关性分析结果表明,NTmax(治疗后24 h)T波恢复直立时间与LVEF水平间呈正相关(r=0.64,P=0.024),T波恢复直立时间与LVEF水平间呈负相关(r=-0.75,P=0.003)。结论通过心电图T波变化与LVEF水平的关联分析,可以更好地指导临床治疗和预测患者的预后。深倒置T波患者可能具有较好的心肌收缩功能,而浅倒置T波患者可能存在心肌收缩功能的损害。因此,在临床实践中,应重视倒置T波的出现,并结合LVEF水平进行综合评估和治疗决策。Objective To investigate the relationship between electrocardiographic T-wave changes and left ventricular ejection fraction(LVEF)in patients with acute anterior interstitial myocardial infarction,and to provide a new basis for the diagnosis and treatment of myocardial infarction.Methods Eighty patients with acute anterior interstitial myocardial infarction admitted to our hospital from March 2020 to April 2023 were selected as the study subjects,and they were divided into an inverted group(n=38)and an upright group(n=42)based on the results of the electrocardiographic T-wave examination.According to the NTmax level of the inversion group,patients with NTax≥10 mm,4~10 mm,and<4 mm were categorized as deep inversion T-wave group(n=11),moderate inversion T-wave group(n=14),and shallow inversion T-wave group(n=13),respectively.The cardiac function indexes of patients in the upright group and inverted group,the LVEF levels of patients with different T-wave recovery times in the upright group,the LVEF levels of patients with different NTmax levels in the inverted group were compared,and the levels of NTmax and LVEF were analyzed by Pearson.Results The LVEF of patients in the inverted group was lower than that of the upright group,and the LVEDV and LVESV were significantly higher than that of the upright group(P<0.05),and there was no difference in the comparison of LVTPFRv of patients in the two groups(P>0.05).Comparison of LVEF levels of patients with different T-wave restoration times of patients in the upright group showed significant differences(P<0.05).The difference in the comparison of LVEF levels in patients with different NTmax levels in the inverted group was significant(P<0.05).The results of the correlation analysis showed a positive correlation(r=0.64,P=0.024)and a negative correlation(r=-0.75,P=0.003)between the time of T-wave return to uprightness and LVEF level at NTmax(24 h after treatment).Conclusion The correlation analysis between electrocardiographic T-wave changes and LVEF levels can better guid

关 键 词：急性心肌梗死 前间壁 心电图 左室射血分数 最深倒置T波 

分 类 号：R542.22[医药卫生—心血管疾病]