心电图对前壁急性心肌梗死发生左心室附壁血栓的预测价值  

Value of the Electrocardiogram for Prediction of Left Ventricular Mural Thrombus in Anterior Wall Acute Myocardial Infarction

作　　者：张富远 韩文杰 

机构地区：[1]河南省信阳市第四人民医院,464100

出　　处：《中西医结合心脑血管病杂志》2003年第2期102-103,共2页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的 :探讨心电图对前壁AMI发生左心室附壁血栓的预测价值。方法 :全部病人均进行心电图检查 ,前 2d每 12h 1次 ,以后每日 1次 ,对第 2天和第 5天心电图ST段和T波方向进行仔细分析。第 5天心脏超声检查观察左心室有否附壁血栓。结果 :AMI后第 2天ST段抬高者 5 3例 (69% ) ,敏感性为 96% ,阳性预测值(PPV )为 3 9% ,阴性预测值(NPV )为 96%。第 2天至第 5天持续ST段抬高和T波直立者 ,特异性为 93 % ,PPV为 71% ;第 2天ST段位于基线 ,而T波倒置者无一例发生附壁血栓。结论 :心电图对前壁AMI发生左心室附壁血栓具有重要预测价值。Objective:To evaluate the predictive value of the electrocardiogram(ECG) on left ventricular mural thrombus(LVMT)in anterior wall acute myocardial infarction(AMI).Methods:Twelve-lead ECG recordings were obtained every 12 hours for the first 48 hours and once daily during the remainder of the hospitalization.The ST-segment and the direction of the T wave of the second to the fifth day were carefully analyzed.Echocardiograpy was applied to observe of LVMT on the fifth day after AMI.Results:ST-segment elevation on the second day after AMI was found in 53(69%) patients,was highly sensitive 96%,and demonstrated PPV of 39%,whereas the NPV was 96%.ST-segment elevation and positive T wave from the second to the fifth day,was found to be highly specific(93%)and to have the highest PPV(71%)for the presence LVMT.None of the patients with an isoelectric ST-segment and negative T wave on the second day had LVMT.Conclusion:ECG had effective prediction of LVMT in anterior wall AML.

关 键 词：心电图 急性心肌梗死 左心室附壁血栓 

分 类 号：R542.22[医药卫生—心血管疾病]