急性心肌梗死患者心电图复极相关参数的变化
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摘要
目的分析急性心肌梗死(acute myocardial infarction,AMI)患者心电图复极相关参数的变化情况,并评估其对胸痛患者临床综合评估的指导作用。方法选取93例经冠状动脉造影证实的AMI患者(AMI组),同时选取年龄、性别与之匹配的正常对照组82例。比较两组心电图肢体导联和胸导联复极相关参数。结果 AMI组肢体导联QT间期、QTc间期和T波时间明显高于正常对照组[(387. 4±36. 9) ms vs.(370. 0±24. 7) ms;(422. 8±35. 6) ms vs.(405. 0±23. 0) ms;(174. 4±26. 8) ms vs.(167. 0±11. 0) ms],且差异均有统计学意义(P <0. 05)。胸导联QT间期、QTc间期和T波时间也明显高于正常对照组[(399. 3±44. 6) ms vs.(368. 9±24. 0) ms;(435. 0±37. 5) ms vs.(404. 2±23. 1) ms;(195. 0±30. 9) ms vs.(174. 9±12. 1) ms],且差异均有统计学意义(P <0. 05)。结论 AMI患者心电图复极时间延长。心电图复极相关参数的变化对胸痛患者的临床综合评估有一定的指导作用。
Objective To analyze the change of indexes related to ECG repolarization in the patients with acute myocardial infarction( AMI),and to judge its instruction for clinical comprehensive evaluation in the patients with chest pain. Methods Ninety-three patients with AMI confirmed by coronary angiography were selected as AMI group while 82 normal controls were simultaneously selected. Cases and controls were matched in age and sex. The indexes related to repolarization in limb and chest leads were compared between the two groups. Results In the AMI group,the QT interval,QTc interval and T wave duration in limb leads were significantly higher than those in the control group[( 387. 4 ± 36. 9) ms vs.( 370. 0 ± 24. 7) ms;( 422. 8 ± 35. 6) ms vs.( 405. 0 ± 23. 0) ms;( 174. 4 ± 26. 8) ms vs.( 167. 0 ± 11. 0) ms]with statistically significant differences( P < 0. 05); the index values in chest leads were also significantly higher[( 399. 3 ± 44. 6) ms vs.( 368. 9 ± 24. 0) ms;( 435. 0 ± 37. 5) ms vs.( 404. 2 ± 23. 1) ms;( 195. 0 ± 30. 9) ms vs.( 174. 9 ± 12. 1) ms]with statistically significant differences( P <0. 05). Conclusion The repolarization time is prolonged on the ECG of AMI patients. Variation of repolarizationrelated indexes are instructive for clinical comprehensive evaluation in the patients with chest pain.
Objective To analyze the change of indexes related to ECG repolarization in the patients with acute myocardial infarction( AMI),and to judge its instruction for clinical comprehensive evaluation in the patients with chest pain. Methods Ninety-three patients with AMI confirmed by coronary angiography were selected as AMI group while 82 normal controls were simultaneously selected. Cases and controls were matched in age and sex. The indexes related to repolarization in limb and chest leads were compared between the two groups. Results In the AMI group,the QT interval,QTc interval and T wave duration in limb leads were significantly higher than those in the control group[( 387. 4 ± 36. 9) ms vs.( 370. 0 ± 24. 7) ms;( 422. 8 ± 35. 6) ms vs.( 405. 0 ± 23. 0) ms;( 174. 4 ± 26. 8) ms vs.( 167. 0 ± 11. 0) ms]with statistically significant differences( P < 0. 05); the index values in chest leads were also significantly higher[( 399. 3 ± 44. 6) ms vs.( 368. 9 ± 24. 0) ms;( 435. 0 ± 37. 5) ms vs.( 404. 2 ± 23. 1) ms;( 195. 0 ± 30. 9) ms vs.( 174. 9 ± 12. 1) ms]with statistically significant differences( P <0. 05). Conclusion The repolarization time is prolonged on the ECG of AMI patients. Variation of repolarizationrelated indexes are instructive for clinical comprehensive evaluation in the patients with chest pain.
引文
[1]陈新.黄宛临床心电图学[M].6版.北京:人民卫生出版社,2010:43-44.
[2]Zareba W,Moss AJ,le Cessie S.Dispersion of ventricular repolarization and arrhythmic cardiac death in coronary artery disease[J].Am J Cardiol,1994,74(6):550-553.
[3]Yan GX,Lankipalli RS,Burke JF,et al.Ventricular repolarization components on the electrocardiogram:cellular basis and clinical significance[J].J Am Coll Cardiol,2003,42(3):401-409.
[4]Watanabe N,Kobayashi Y,Tanno K,et al.Transmural dispersion of repolarization and ventricular tachyarrhythmias[J].J Electrocardiol,2004,37(3):191-200.
[5]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:242-248.
[6]中华医学会心电生理和起搏分会心电图学学组.心电图测量标准化[J].中华心律失常学杂志,1998,2(2):119-121.
[7]Cinca J,Figueras J,Tenorio L,et al.Time course and rate dependence of Q-T interval changes during noncomplicated acute transmural myocardial infarction in human beings[J].Am J Cardiol,1981,48(6):1023-1028.
[8]Kenigsberg DN,Khanal S,Kowalski M.Prolongation of the QTc interval is seen uniformly during early transmural ischemia[J].J Am Coll Cardiol,2007,49(12):1299-1305.
[9]李阳.急性心肌梗死患者心电图QT间期离散度的变化特点[J].临床合理用药,2018,11(4):93-94.
[10]Halkin A,Roth A,Lurie I,et al.Pause-dependent Torsade de pointes following acute myocardial infarction:a variant of the acquired long QT syndrome[J].J Am Coll Cardiol,2001,38(4):1168-1174.
[11]楚英杰,刘晓宇.缺血性QT间期异常[J].中国心脏起搏与心电生理杂志,2011,25(5):450-452.
[12]邓亨平.QT间期与急性ST抬高型心肌梗死患者梗死部位、心律失常类型及预后的关系[J].中外医学研究,2016,14(6):6-7.
[2]Zareba W,Moss AJ,le Cessie S.Dispersion of ventricular repolarization and arrhythmic cardiac death in coronary artery disease[J].Am J Cardiol,1994,74(6):550-553.
[3]Yan GX,Lankipalli RS,Burke JF,et al.Ventricular repolarization components on the electrocardiogram:cellular basis and clinical significance[J].J Am Coll Cardiol,2003,42(3):401-409.
[4]Watanabe N,Kobayashi Y,Tanno K,et al.Transmural dispersion of repolarization and ventricular tachyarrhythmias[J].J Electrocardiol,2004,37(3):191-200.
[5]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:242-248.
[6]中华医学会心电生理和起搏分会心电图学学组.心电图测量标准化[J].中华心律失常学杂志,1998,2(2):119-121.
[7]Cinca J,Figueras J,Tenorio L,et al.Time course and rate dependence of Q-T interval changes during noncomplicated acute transmural myocardial infarction in human beings[J].Am J Cardiol,1981,48(6):1023-1028.
[8]Kenigsberg DN,Khanal S,Kowalski M.Prolongation of the QTc interval is seen uniformly during early transmural ischemia[J].J Am Coll Cardiol,2007,49(12):1299-1305.
[9]李阳.急性心肌梗死患者心电图QT间期离散度的变化特点[J].临床合理用药,2018,11(4):93-94.
[10]Halkin A,Roth A,Lurie I,et al.Pause-dependent Torsade de pointes following acute myocardial infarction:a variant of the acquired long QT syndrome[J].J Am Coll Cardiol,2001,38(4):1168-1174.
[11]楚英杰,刘晓宇.缺血性QT间期异常[J].中国心脏起搏与心电生理杂志,2011,25(5):450-452.
[12]邓亨平.QT间期与急性ST抬高型心肌梗死患者梗死部位、心律失常类型及预后的关系[J].中外医学研究,2016,14(6):6-7.