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目的探讨心电图对应导联ST段压低(ST-segmentdepression,STD)在急性心肌梗死的临床价值。方法选取某院2002年3月～2011年2月诊治的500例初发急性心肌梗死患者的临床资料及心电图检查结果进行回顾性分析,心电图对应导联STD≥0.1mV共238例,设为观察组,对应导联ST段无压低或STD﹤0.1mV共262例,设为对照组。对比观察两组患者冠状动脉狭窄率和多支病变率以及严重心律失常、心力衰竭、心源性休克的发生率和急性心梗死亡率。结果观察组冠状动脉狭窄率和多支病变率分别为66.39%(158/238)和25.63%(61/238),明显高于对照组44.27%(116/262)和8.78%(23/262),差异有统计学意义(P﹤0.05)。观察组严重心律失常和心力衰竭发生率分别为17.65%、16.81%,明显高于对照组4.58%、4.20%,差异有统计学意义(P﹤0.05)。两组心源性休克发生率和死亡率比较,差异无统计学意义(P﹥0.05)。结论急性心肌梗死伴心电图对应导联STD预示病情严重,临床应及早采取干预治疗措施,防止患者病情恶化。
Objective To investigate the clinical value of ST-segment depression (STD) in ECG-induced acute myocardial infarction (AMI). Methods A retrospective analysis was performed on the clinical data and ECG findings of 500 patients with newly diagnosed acute myocardial infarction who were diagnosed and treated from March 2002 to February 2011 in our hospital. There were 238 cases with STD ≥0.1mV in ECG. Group, the corresponding lead ST segment without depression or STD <0.1mV a total of 262 cases, as the control group. The incidence of coronary stenosis and multivessel disease, severe arrhythmia, heart failure, cardiogenic shock and acute myocardial infarction were compared between the two groups. Results The rate of coronary stenosis and multivessel disease in the observation group were 66.39% (158/238) and 25.63% (61/238) respectively, which were significantly higher than those in the control group (44.27% (116/262) and 8.78% (23/262) , The difference was statistically significant (P <0.05). The incidences of severe arrhythmia and heart failure in the observation group were 17.65% and 16.81%, respectively, which were significantly higher than those in the control group (4.58% and 4.20%, P <0.05). There was no significant difference between the two groups in the incidence of cardiogenic shock and mortality (P> 0.05). Conclusion Acute myocardial infarction with electrocardiogram corresponding lead STD predicts a serious condition, and clinical interventions should be taken as soon as possible to prevent the patient’s condition from deteriorating.