心电图对应导联ST段压低在急性ST段抬高型心肌梗死诊治及预后价值的回顾性分析

魏宇淼; 陈芬; 邓珊; 张家明; 王祥; 程翔; 曾秋棠; 廖玉华

doi:10.13201/j.issn.1001-1439.2015.05.010

心电图对应导联ST段压低在急性ST段抬高型心肌梗死诊治及预后价值的回顾性分析

- 华中科技大学同济医学院附属协和医院心血管病研究所(武汉, 430022)
基金项目:
国家自然科学基金资助(No:30871069、81470483)

详细信息

作者简介:
廖玉华,E-mail:liaoyh27@163.com

中图分类号: R542.2

收稿日期: 2015-04-04

A retrospective analysis on the role of corresponding electrocardiogram ST-segment depression in acute ST-segment elevation myocardial infarction

- Institute of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

Received Date: 04 April 2015

摘要

摘要: 目的:探讨急性ST段抬高型心肌梗死患者心电图对应导联压低对患者诊治及预后的预测价值。方法:收集我院心内科冠心病监护病房急性ST段抬高型心肌梗死患者心电图存在对应性压低的患者共102例,选取同期心电图提示相似心肌梗死部位,且临床特征具有可比性的无明显对应性压低的急性ST段抬高型心肌梗死患者102例作为对照。观察两组患者冠脉闭塞部位、左室射血分数及心肌肌钙蛋白I和NT-proBNP水平,记录患者住院期间发生的严重心肌梗死并发症和死亡事件。分析存在对应性ST段压低与无显著压低对照组患者的冠脉闭塞部位、心脏功能及临床心血管事件的差异。结果:急性ST段抬高型心肌梗死伴有对应性ST段压低的患者,其心肌梗死面积显著大于不伴有对应性压低的患者,其心脏左室功能、心肌梗死并发症及存活率均显著低于不伴对应性压低的患者。且急性ST段抬高型心肌梗死同时伴有的对应性导联压低对冠脉闭塞部位具有较好的判断作用。结论:临床上应高度重视ST段抬高型心肌梗死患者的对应性ST段压低,是评估心肌梗死患者病情和预后的重要手段。
- 急性ST段抬高型心肌梗死 /
- 对应性ST段压低 /
- 冠状动脉闭塞部位 /
- 严重心肌梗死并发症 /
- 预后
Abstract: Objective:To investigate the corresponding electrocardiogram ST-segment depression in the diagnosis and prognosis in the acute ST-segment elevation myocardial infarction.Method:We collected 102 acute ST-segment elevation myocardial infarction patients with corresponding electrocardiogram ST-segment depression from coronary intensive care unit in our hospital,and we collected 102 acute ST-segment elevation myocardial infarction patients without corresponding electrocardiogram ST-segment depression in the same period as control group.We observed the coronary occlusion site through coronary angiography,assessed the left ventricular ejection fraction,cardiac troponin I and NT-proBNP levels,and recorded the severe myocardial infarction complications and cardiac death events during hospitalization between the two groups.We analyzed the differences in the coronary artery occlusion site,cardiac function and clinical events between the two groups.Result:We found the infarct size in the acute ST-segment elevation myocardial infarction patients with corresponding ST-segment depression was significantly larger than in the patients who were not associated with depression,and the left ventricular function,myocardial infarction complications and survival rates were significantly lower than in the patients without corresponding ST-segment depression.And the electrocardiogram corresponding ST-segment depression was a key point to determine the occluded coronary artery site.Conclusion:The electrocardiogram corresponding ST-segment depression has great value in determining the condition and prognosis of myocardial infarction in the patients with acute ST-segment elevation myocardial infarction.
- acute ST-segment elevation myocardial infarction /
- corresponding ST-segment depression /
- site of occluded coronary artery /
- severe myocardial infarction complications /
- prognosis

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参考文献(10)

[1]	中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志, 2010,38(8):675-690.
[2]	O'Gara P T, Kushner F G, Ascheim D D, et al. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J]. Circulation, 2013,127:e362-425.
[3]	LI W, CHEN Y, LI S, et al. Agonistic antibody to angiotensin II type 1 receptor accelerates atherosclerosis in ApoE-/-mice[J]. Am J Transl Res, 2014, 6:678-690.
[4]	LI W, LI Z, CHEN Y, et al. Autoantibodies targeting AT1 receptor from patients with acute coronary syndrome upregulate proinflammatory cytokines expression in endothelial cells involving NF-κB pathway[J]. J Immunol Res, 2014, 2014:342693.
[5]	WEI Y, CHEN Y, LI Z, et al. Expression of NADPH oxidase and production of reactive oxygen species in aorta in an active immunization mouse model with AT1-EC2 peptide[J]. J Huazhong Univ Sci Technolog Med Sci, 2012, 32:490-494.
[6]	武汉市医学会心血管病专业委员会;临床心血管病杂志编辑委员会.武汉市心血管病专业委员会关于2013年国际血脂指南的专家共识[J].临床心血管病杂志,2014, 30(3):183-184.
[7]	耿慧,刘梅.血脂领域的新进展[J].临床心血管病杂志,2014, 30(2):95-98.
[8]	LIBBY P. Current concepts of the pathogenesis of the acute coronary syndromes[J]. Circulation, 2001, 104:365-372.
[9]	ZIMETBAUM P J, JOSEPHSON M E. Use of the electrocardiogram in acute myocardial infarction[J]. N Engl J Med,2003, 348:933-940.
[10]	The GUSTO investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction[J]. N Engl J Med, 1993, 329:673-682.