演变为ST段抬高型心肌梗死的De Winter综合征患者临床特点及心电图特征分析  

Clinical Features and Electrocardiogram Characteristics of Patients with De Winter Syndrome Evolving into ST Elevation Myocardial Infarction

作　　者：赵秀平 刘东升 刘娜 王艳琳 ZHAO Xiuping;LIU Dongsheng;LIU Na;WANG Yanlin(Department of Cardiology,Cangzhou People's Hospital,Cangzhou 061001,China)

机构地区：[1]河北省沧州市人民医院心内科,061001

出　　处：《实用心脑肺血管病杂志》2025年第5期73-76,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的分析演变为ST段抬高型心肌梗死(STEMI)的De Winter综合征患者的临床特点及心电图特征。方法2018-01-16至2022-01-29,沧州市人民医院共收治了75例De Winter综合征患者,其中演变为STEMI的患者50例,根据纳入与排除标准选取其中的49例患者为De Winter组。另选取同期沧州市人民医院收治的STEMI患者745例为STEMI组。回顾性收集两组患者的临床资料及De Winter组患者心电图检查结果。结果De Winter组男性占比高于STEMI组,年龄小于STEMI组(P<0.05)。De Winter组中,J点压低最深导联为V2导联者2例(4.1%)、V3导联者12例(24.5%)、V4导联者16例(32.7%)、V5导联者18例(36.7%)、V6导联者1例(2.0%),所有患者平均J点压低深度为(2.37±1.22)mm;T波振幅最高导联为V2导联者17例(34.7%)、V3导联者28例(57.1%)、V4导联者4例(8.2%),所有患者平均T波振幅为(11.59±3.45)mm;aVR导联ST段抬高者45例(91.8%)、正常者4例(8.2%),Ⅱ导联ST段压低者37例(75.5%)、正常者12例(24.5%),Ⅲ导联ST段抬高者2例(4.1%)、压低者29例(59.2%)、正常者18例(36.7%),aVF导联ST段压低者33例(67.3%)、正常者16例(32.7%);胸痛至出现De Winter图形时间为96.0(125.5)min;出现De Winter图形至出现STEMI图形时间为586.0(1526.5)min。结论演变为STEMI的De Winter综合征患者多为青年男性;其心电图特点为J点压低最深者以V5导联最多,T波振幅最高者以V3导联最多,aVR导联ST段抬高者较多,下壁导联ST段压低者居多。Objective To analyze the clinical features and electrocardiographic characteristics of patients with De Winter syndrome evolving into ST elevation myocardial infarction(STEMI).Methods From January 16,2018 to January 29,2022,a total of 75 patients with De Winter syndrome were treated in Cangzhou People's Hospital,of which 50 patients evolved into STEMI.According to the inclusion and exclusion criteria,49 patients were selected as the De Winter group.Another 745 STEMI patients admitted to Cangzhou People's Hospital during the same period were selected as the STEMI group.Clinical data of the two groups and electrocardiogram results of the De Winter group were retrospectively collected.Results The proportion of males in De Winter group was higher than that in STEMI group,and the age was younger than that in STEMI group(P<0.05).In the De Winter group,the deepest J-point depression occurred in 2 cases(4.1%)of V2 leads,12 cases(24.5%)of V3 leads,16 cases(32.7%)of V4 leads,18 cases(36.7%)of V5 leads,and 1 case(2.0%)of V6 leads,and the average J-point depression depth of all patients was(2.37±1.22)mm;the highest T-wave amplitude was found in 17 cases(34.7%)of V2 leads,28 cases(57.1%)of V3 leads,and 4 cases(8.2%)of V4 leads,and the average T-wave amplitude of all patients was(11.59±3.45)mm;there were 45 cases(91.8%)of ST segment elevation and 4 cases(8.2%)of normal in aVR leads,37 cases(75.5%)of ST segment depression and 12 cases(24.5%)of normal in leadⅡ,2 cases(4.1%)of ST segment elevation,29 cases(59.2%)of depression and 18 cases(36.7%)of normal in leadⅢ,33 cases(67.3%)of ST segment depression and 16 cases(32.7%)of normal in lead aVF;the time from onset to appearance of De Winter pattern was 96.0(125.5)min;the time from the appearance of De Winter pattern to the appearance of STEMI pattern was 586.0(1526.5)min.Conclusion Patients with De Winter syndrome who evolve into STEMI are mostly young males.The characteristics of the electrocardiogram shows that the deepest J point depression is most common in lead V5,the hi

关 键 词：ST段抬高型心肌梗死 DeWinter综合征 临床特点 心电图 

分 类 号：R542.22[医药卫生—心血管疾病]