根据心电图异常特征对急性心肌梗死患者进行危险判定及预后分析

摘要

Objective To assess the risk of acute myocardial infarction (AMI) and analyze its out‐come by studying the abnormal ECG presentations in AMI patients .Methods The clinical data and ECG presentations of 381 AMI patients were retrospectively analyzed .The abnrmal ECG presentations and the mortalty were comparatively analyzed in AMI patients with multiple lead pathological Q wave ,elevated ST‐segment ,atrial fibrillation (AF) ,bundle branch conduction block ,cardiogenic shock ,and heart failure .Results T he incidence of cardiogenic shock ,heart fail‐ure and the mortality were significantly higher in patients with multiple lead pathological Q wave than in those without multiple lead pathological Q wave (58 .1% vs 21 .4% ,54 .3% vs 23.2% , 40.0% vs 6 .5% ,P<0 .05) and in patients with abnormal presentations such as elevated ST‐seg‐ment and AF than in those without abnormal ECG presentations (P<0 .05 ,P<0 .01) .Conclusion Abnormal ECG presentations ,such as multiple lead pathological Q wave ,can be used as the evi‐dence for the risk and outcome of AMI .%目的：探讨急性心肌梗死患者的心电图异常特征，对急性心肌梗死进行危险判定及预后分析。方法回顾性分析381例急性心肌梗死患者住院期间的临床及心电图资料，对有无多导联病理性Q波、多导联S T 段抬高、心房颤动和束支传导阻滞等10项异常心电图指标合并心源性休克、心力衰竭及病死率进行比较分析。结果有多导联病理性Q波患者较无异常患者心源性休克（58．1％ v s 21．4％）、心力衰竭（54．3％ v s 23．2％）和病死率（40．0％ v s 6．5％）明显升高（P＜0．05），有多导联ST段抬高、心房颤动等8项异常指标较无异常患者的心源性休克、心力衰竭和病死率明显升高（ P＜0．05，P＜0．01）。仅有无二度以上房室传导阻滞的患者心源性休克、心力衰竭和病死率无明显差异（P＞0．05）。结论多导联病理性Q波等异常心电图指标能够作为急性心肌梗死危险判定及预后依据。