| 周慧成.心电图QRS波终末变形对急性下壁心肌梗死患者预后的影响[J].浙江中西医结合杂志,2016,26(2): |
| 心电图QRS波终末变形对急性下壁心肌梗死患者预后的影响 |
| The Effects of QRS Wave Terminal Deformation on the Electrocardiogram on Prognosis in Patients with Acute InferiorWall Myocardial Infarction |
| 投稿时间：2015-06-14 修订日期：2015-08-03 |
| DOI： |
| 中文关键词: 急性心肌梗死 心电图 QRS波终末变形 预后 |
| 英文关键词:acute myocardial infarction. electrocardiogram QRS wave terminal deformation prognosis |
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| 中文摘要: |
| 【】目的：探讨心电图QRS波终末变形对急性下壁心肌梗死患者预后的影响。方法：回顾性分析2008年2月-2014年6月在我院心内科住院确诊的急性下壁心肌梗死患者86例,根据入院后首份12导心电图是否有QRS波终末变形,分为观察组(首份心电图有QRS波终末变形)和对照组(首份心电图无QRS波终末变形)。观察入院时和溶栓2小时后心电图和心肌酶谱变化情况,住院期间并发症的情况(心力衰竭、心源性休克、室性心动过速或心室颤动、心动过缓或房室传导阻滞等心律失常)及住院期间死亡人数。出院时用彩色多普勒超声心动图检查左心功能,记录左心室射血分数(EF)。随访1年后观察两组患者再发心肌梗死情况及病死率。结果：两组患者在年龄、性别、吸烟史、高血压病史、糖尿病史、高脂血症史、从开始出现症状到静脉溶栓的时间、补救PCI和择期PCI方面差异无统计学意义(P>0.05)。人院时,观察组患者ST段抬高的幅度(∑ST)明显高于对照组(P<0.01)；溶栓2小时后,观察组∑ST仍明显高于对照组(P<0.01)；两组ST段回落情况比较,观察组少于对照组(P<0.05)；观察组CK-MB峰值明显高于对照组(P <0.01)。观察组患者住院期间室性心律失常、三度房室传导阻滞及心源性休克的发生率均较对照组高(P均<0.05)；观察组左室射血分数较对照组低(P <0.01)。观察组随访1年后再发心肌梗死人数及死亡人数明显高于对照组(P均<0.05)。结论：急性下壁心肌梗死QRS波终末变形可以预测患者病情及预后,有助于患者选取最佳的再灌注治疗方法,对改善患者心功能,提高生存质量及降低远期并发症具有重要的意义,值得临床推广应用。 |
| 英文摘要: |
| Object: To explore the effects of QRS wave terminal deformation on the electrocardiogram on prognosis in patients with acute inferior wall myocardial infarction.Methods: A total of 86 patients with acute inferior wall myocardial infarction were analyzed retrospectively between February,2008 and June ,2013. According to the first admission ECG whether QRS wave terminal deformation,the patients were divided into the observation group and the control group. The changes of electrocardiogram and myocardial enzymes were observed at the tine of admission and 2 hours after thrombolytic spectrum.. In hospital complications and in-hospital deaths were observed. When the patients were released from the hospital ,left ventricular function were measured with color Doppler ultrasound Beckoning and the left ventricular ejection fraction (EF) were recorded. After 1 years of follow-up observation of two groups of patients, recurrent and fatality rate of acute myocardial infarction were observed. Results: There was no statistical significance in the sex,age, smoking history, history of hypertension, diabetes, hyperlipidemia history, appear symptoms to intravenous thrombolytic time, remedial PCI and selective PCI（P >0.05）. The hospital, patients with ST segment elevation amplitude (∑ ST) was significantly higher than the control group（P<0.01）. 2 hours after thrombolytic therapy, the observation group ∑ ST was higher than that of control group（P <0.01）. The ST segment resolution was less in the observation group than the control group（P <0.05）. The peak value of CK-MB in the observation group was significantly higher than that in control group（P<0.01）.The incidence rate of ventricular arrhythmia , three degree atrioventricular block and cardiogenic shock in the observation group during hospitalization were higher than those in control group. In observation group, the left ventricular ejection fraction was lower than that in control group（P <0.01）. The number of deaths and recurrent myocardial infarction in the observation group were higher than those of control group after 1 years of follow-up .Conclusion: QRS wave terminal deformation on the electrocardiogram can predict the condition and prognosis of patients with acute inferior wall myocardial infarction. It has important significance to improve the heart function and the quality of life of patients and to reduce long-term complications. |
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