ST段抬高型急性心肌梗死合并J波综合征患者的心电图特征

摘要

目的:探讨ST段抬高型急性心肌梗死(STEMI)并发J波综合征患者的心电图特征及意义.方法:从我院收治的STEMI患者中筛选出300例作为研究对象,其中出现J波综合征的有59例(J波综合征组),未出现J波综合征的有241例(无J波综合征组).J波综合征组又根据存活情况分为死亡组(12例)和存活组(47例).测量患者入院第一次所做的12导联心电图每个导联的 QT间期,找出其 QT间期的最小值及最大值,并计算其离散度(QTd).记录两组患者出现室性心律失常、死亡及梗死部位等情况.结果:J波综合征组QTd明显大于无J波综合征组[(52 ± 25)ms比(47 ± 22)ms,P= 0.003].与无 J波综合征组比较,J波综合征组发生室性心律失常(16.6% 比30.5%)、死亡率(6.6% 比20.3%)、前壁心梗(44.8% 比76.3%)发生率明显升高.在J波综合征组中,与存活组比较,死亡组QT间期最小值明显减小[(363 ± 33)ms比(319 ± 31)ms],QTd[(45 ± 22)ms比(80 ± 22)ms]值明显增大(P<0.05或<0.01).结论:ST段抬高型急性心肌梗死并发J波综合征的原因可能与QTd增大有关,并发J波综合征将会导致严重心律失常、死亡的风险增加.%Objective:To analyze ECG features of patients with ST elevation acute myocardial infarction(STEMI) complicated J wave syndrome(JWS),and its significance.Methods:A total of 300 STEMI patients treated in our hospital were screened,including 59 cases with JWS(JWS group)and 241 cases without JWS(no JWS group).Ac-cording to survival condition,JWS group was divided into death group(n=12)and survival group(n=47).QT in-terval of every lead on the first 12-lead ECG examination after hospitalization was measured,and minimum and maximum value of QT interval were discovered,then QT interval dispersion(QTd)was calculated.Incidence of ventricular arrhythmia,death and infarct location were recorded in two groups.Results:QTd of JWS group was sig-nificantly longer than that of no JWS group[(52 ± 25)ms vs.(47 ± 22)ms,P=0.003].Compared with no JWS group,there were significant rise in incidence rates of ventricular arrhythmia(16.6% vs.30.5%),death(6.6%vs.20.3%)and anterior wall myocardial infarction(44.8% vs.76.3%)in JWS group.In JWS group,compared with survival group,there was significant reduction in minimum value of QT interval[(363 ± 33)ms vs.(319 ± 31) ms]and significant rise in QTd[(45 ± 22)ms vs.(80 ± 22)ms]in death group.P<0.05 or <0.01. Conclusion:The cause of STEMI complicated J wave syndrome may be related to increased QTd.It complicated J wave syndrome will lead to increased risk of serious arrhythmias and death.