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老年人急性心肌梗死心电图墓碑形ST 段抬高临床特点和意义预后(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2004年第6期
页码:
560-561
栏目:
临床研究
出版日期:
2004-11-01

文章信息/Info

Title:
Cl inical Characteristic and signif icance of ECGtombstoning of ST segment elevation in aged people with acute myocardial infarction
作者:
于文江; 王春雨
烟台毓璜顶医院, 山东烟台264000
Author(s):
YU Wen - jiang ;  WANG Chun - yu
Yantai Yuhuangding Hospital , Yantai , Shandong 264001 ,China
关键词:
心肌梗死; 急性; ST 段抬高; 墓碑形; 老年人
Keywords:
myocardial infarction ; acute ST segment ;  tombstoning ;  old people
分类号:
R
DOI:
-
文献标识码:
A
摘要:
目的: 研究墓碑形ST 段抬高急性心肌梗死(AMI) 早期或超急性期严重心肌损伤的表现形式,探讨老年人近期预后。方法: 1981-01～1998 - 12 收治AMI 患者1359 例,根据心电图ST 段抬高形式其中有墓碑形65 例,根据年龄分墓碑形老年阻48 例,非老年组17 例,另随机选通常形60 例为对照组进行多项指标分析。结果: 墓碑形组大量吸烟、基础疾病以高血压并发冠心病,前壁或复合前壁AMI 发生率高( P < 0. 05) 。墓碑老年组发生率,CK峰 值/ Ptfv1 负值增大,ST 段振幅抬高,QTc 间期延长,对应性ST 段下移及并发恶性心律失常/ 泵衰竭、梗死后心绞痛、心肌梗死扩展和1 周内病死率明显高于非老年组( P < 0. 05 , P < 0. 01) 。结论: 墓碑形ST 段抬高是AMI 近期预后险恶的重要指标。
Abstract:
AIM: To study the tombstoning of ST segment elevation at the early or hyper - acute stage of the old people′s acute myocardial infarction (AMI) and it s prognostic significance. METHODS:65 cases of AMI with tombstoning of ST segment elevation in ECG(48 in the old tombstoning group and 17 in the non - old tombstoning group) were analysed for various parameters. RESULTS: ST segment amplitudes elevat ,Ptfv1 ,peak values of serum CK, QTc prolonged ST segmended of opposite descended in the old people group ( P < 0. 05 , P < 0. 01) . Most of the old people group suffered anterior wall AMI complicated with pump failure ,infarct extension , angina ,walignant arrtythmia , and AMI expansion. CONSLUSION:First week death rate was significantly higher in the old patient s. Tombstoning of ST segment elevation in the old AMI patient s AMI is an independent parameter indicating short- term prognosis.

参考文献/References

[1] Wimalaratna H. SK“Tombstoning”of ST segment in AMI [ J ] . Lancet ,1993 :243 :496 - 499.

[2 ] 于文江,彭丽岚,仲崇斐,等. 墓碑形ST 段抬高对急性心肌梗死患者近期预后的影响[J ] . 中国循环杂志,1996. 11 (10) ,592 - 594.

[ 3 ] 翟恩祖. 冠心病患者P 波终末向量检测意义的探讨[J ] . 上海医学,1980 ,13 :386 - 387.

[ 4 ] Clemmensen P , Grande P , Icdrich HR , et al . Evialuation of formulasforestimating the final size of acute myocardial infarcts fromguantitative ST - segment elevation on the initial stamdard 12- 1ead ECG[J ] . Elect rocardiol , 1991 ,24 :77 - 79.

[5 ] 王湘生. 现代心脏性猝死- 高危患者的检测、防治[M] . 长沙: 湖南科学技术出版社,1994. 34 - 35.

备注/Memo

备注/Memo:
收稿日期：2003-11-22
更新日期/Last Update: 2004-11-01