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吸烟量对急性心肌梗死墓碑形ST 段患者临床预后的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2004年第5期
页码:
462-463
栏目:
临床研究
出版日期:
2004-09-01

文章信息/Info

Title:
Effect of smoking on short-term prognosis of ECG tombstoning of ST segment elevation
作者:
彭丽岚1; 于文江2
1. 解放军烟台疗养院,山东烟台264001 ;2. 烟台毓璜顶医院,山东烟台264000
Author(s):
PENG Li-lian1; YU Wen-jiang2
11PLA Yantai Sanaiorium , Yantai , Shandong 264001 , China
关键词:
心肌梗塞; 急性; ST段; 墓碑形; 吸烟
Keywords:
myocardial infarction ; tombstoning ST segment ; smoking
分类号:
R542. 22
DOI:
-
文献标识码:
A
摘要:
目的: 探讨吸烟量对急性心肌梗死(AMI) 早期墓碑形ST 段抬高患者发病年龄、临床险恶特点和心电图特征的影响。方法:分析心电图检测AMI 早期墓碑形ST段抬高患者59 例中不吸烟11 例,少量吸烟18 例,大量吸烟30例的临床特点和心电图某些指标。结果:吸烟患者占81 % ,其中大量吸烟患者占63 %。吸烟者AMI 发病年龄提前,前壁或复合前壁多见,并发泵衰竭,恶性心律失常、MI 扩展发生比例大( P < 0. 05) 。1 周内病死率高( P < 0. 01) ,心电图指标PTFv1 负值增大,QTc 间期延长、ST段抬高/ 振幅加大和血清肌酸激酶显著升高( P < 0. 05) 均以大量吸烟居多。吸烟量越大时间越长,AMI 病死率相对危险度越高。结论:吸烟能影响墓碑形ST 段抬高AMI 患者的近期预后。
Abstract:
AIM: To study the effects of smoking on the age , clinical and ECGfeatures of the AMI patients with early-stage tombstone ST segment elevation. METHODS : Clinical and ECGfeatures of the 59 AMI patients with early-stage tombstone ST segment elevation were determined , of whom 11 were non2smokers , 18 , milder smokers and 30 , heavy smokers. RESULTS : Of the 59 patients , smokers accounted for 81 % and among the smokers heavy smokers accounted for 63 %. Among the smokers , the age for the onset of AIM was getting younger and the infarcts in the tombstone were in the anterior wall ( P < 0. 05) . The incidence of complications such as pump failure , infarct expansion , angina pectoris and malignant arrhythmia ( P < 0. 05) and the first week death rate ( P < 0. 01) were much higher than those of the non2smokers. Also , PTFv1 value increased , ST segment was elevated and amplified , and the serum CK values grew significantly in the heavy smokers ( P < 0. 05 or P < 0. 01) . CONCLUSION: Smoking causes the tombstone ST segment elevation in AMI patients , which suggests a poor short-term prognosis.

参考文献/References

[1 ] Clemmensen P , Grande P , Icdrich HR , Evaluation of formulas for estimating the final size of acute myocaradial infarcts form quantitative ST-segment elevation on the initial standard 122lead ECG[J ] . Electrocardiol , 1991 , 24 : 77 - 79.

[ 2 ] Tnnesen P , Nrregaard J , Mikkelsen K. A double-blind trial of a nicotine inhaler for smoking cessation[J ] . JAMA ,1993 , 269 :1268 - 1271.

[3 ] 罗小玲,高　旭,钱冠清. 吸烟对血管内皮细胞的损伤及其预防 [J ] . 中国病理生理杂志,1994 ,10(8) :1 - 10.

[4 ] 郑豪义,戴玉华,张丽华. 内皮细胞损伤与急性心肌梗死[J ] . 中华心血管病杂志,1997 ,25(6) :436 - 438.

备注/Memo

备注/Memo:
收稿日期：2003-11-22
更新日期/Last Update: 2004-09-01