【摘要】 目的:评估心电图联合临床危险因素对急性心肌梗死猝死患者的预警作用。方法:将2012年4月-2014年4月于我院接受治疗的60例急性心肌梗死伴恶性心律失常患者作为观察组,选取同期急性心肌梗死未伴心律失常的50例患者作为对照组,两组患者均接受心电图监测,记录患者Q-T间期、QRS时间、J波、Tp-e间期等指标变化情况,统计两组患者LVEF(左心室射血分数)值,对两组患者均实施为期半年的随访调查,统计心脏性猝死发生率,并分析临床危险因素在急性心肌梗死猝死高危患者中的预警作用。结果:观察组QRS时间为(125.7±36.3)ms,高于对照组,Q-Td值为(86.3±19.3)ms,Tp-e值为(156.5±20.7)ms,均高于对照组,其中14例出现J波,占23.3%,高于对照组的6.0%,有碎裂QRS波群18例,占30.0%,高于对照组的10.0%,心脏性猝死30例,占50.0%,同样高于对照组的30.0%,且其LVEF值为(47.1±10.2)%,低于对照组(P<0.05)。结论:J波的出现、Tp-e间期的延长与LVEF值的降低均为急性心肌梗死患者出现恶性心律失常的相关危险因素,其中Tp-e关联性最强,危险度最高。临床上必须重视对急性心肌梗死患者Tp-e间期的监测,以降低心脏性猝死的发生率。更多还原

【Abstract】 Objective:To evaluate the warning effect of electrocardiogram combined with clinical risk factors on and sudden death patients with high risk.Methods:60cases of acute myocardial infarction patients with malignant arrhythmia from April 2012 to April 2014 in our hospital were selected as observation group,50 cases of acute myocardial infarction complicated with arrhythmia patients as control group,patients were given the ECG monitoring,recorded the patient Q-T interval,QRS time,J wave,the Tp-e interval index variation,statistics of LVEF(left ventricular ejection fraction)values of two groups,implementation of a half year follow-up investigation,statistics the incidence of sudden cardiac death,and analyzed the warning effect of clinical risk factors on sudden death and acute myocardial infarction in patients with high risk.Results:In observation group,QRS time for(125.7±36.3)ms,was higher than that of control group,the Q-Td value was(86.3±19.3)ms,the Tp-e value was(156.5±20.7)ms,was higher than those in control group,including 14 cases of J wave,accounted for 23.3%,was higher than that of the control group of 6.0%,18 have fragmented QRS complexes cases,accounting for 30.0%,was higher than the control group of 10.0%,30 cases of sudden cardiac death,accounting for 50.0%,also higher than that of the control group of 30.0%,and LVEF value was(47.1±10.2)%,was lower than control group(P<0.05).Conclusion:The Appearance of J wave,the extended Tp-e and reduced LVEF values were related risk factors of acute myocardial infarction patients with fatal arrhythmia,of which Tp-e has the strongest correlation,the greatest risk.The clinical importance must be attached to the monitoring of acute myocardial infarction on Tp-e interval,in order to reduce the incidence of sudden cardiac death.更多还原