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目的探讨急性心肌梗死(acute myocardial infarction,AMI)墓碑形ST段抬高的临床意义。方法将86例AMI患者以ST段抬高的特征分为两组,墓碑形抬高组36例、其他形抬高组50例。观察两组的一般临床资料(年龄、有否合并糖尿病),并比较两组AMI的发生部位、PCI前心梗后心绞痛、并发症及死亡的发生率、首次CK值、各项心电指标及PCI后心肌缺血再灌注损伤的发生率。结果两组各项临床指标及心电图指标差异均有统计学意义;墓碑形ST段抬高组PCI后心肌缺血再灌注损伤的发生率亦明显高于其他形ST段抬高组。结论墓碑形ST段抬高患者梗死部位特殊而广泛、并发症多、死亡率高、易出现心肌缺血再灌注损伤,对此类患者应高度重视并积极预防心肌缺血再灌注损伤的发生。
Objective To investigate the clinical significance of tombstoning ST segment elevation in acute myocardial infarction (AMI). Methods Eighty-six patients with AMI were divided into two groups according to the characteristics of ST segment elevation. Tombstone-shaped elevated group (36 cases) and other shaped elevated group (50 cases). The clinical data of the two groups (age, with or without diabetes mellitus) were observed. The incidence of AMI, the incidence of post-PCI angina pectoris, complications and death, the first CK value, The incidence of myocardial ischemia-reperfusion injury after PCI. Results There were significant differences in clinical indexes and ECG indexes between the two groups. The incidence of myocardial ischemia-reperfusion injury after tombstoning ST-segment elevation was significantly higher than that of other ST-segment elevation. Conclusion Tombstone-shaped ST segment elevation patients with special and wide range of infarction, complications, high mortality, prone to myocardial ischemia-reperfusion injury, such patients should attach great importance and actively prevent myocardial ischemia-reperfusion injury.