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目的对急性心肌梗死后左室重构的临床危险因素进行评估。方法将进入本观察的５１例病人，按溶栓治疗后，有无Ｑ波形成，分为Ｑ波组和非Ｑ波组，全部病人入住ＣＣＵ，并在入院即刻及入院后８、１６、２４、４８和７２小时分别进行血清心肌酶学检查。对其中３４例病人在心梗后１周和６周行超声心动图检查，并测定左室质量指数。结果Ｑ波组血清ＣＰＫ峰值（１３４７５８±２２０３３）ＩＵ，左室质量指数在心梗后１周和６周分别为（２３４２８±９２３６）ｇ·ｍ－２、（２７１５２±９３１２）ｇ·ｍ－２，均明显高于非Ｑ波组，随访半年表明新近出现心衰亦明显高于非Ｑ波组。结论溶栓后的有Ｑ波出现，血清ＣＰＫ峰值高于５００ＩＵ，左室质量指数＞２２０ｇ·ｍ－２，是急性心肌梗死后左室重构的危险因素。
Objective To evaluate the clinical risk factors of left ventricular remodeling after acute myocardial infarction. Methods Fifty-one patients who entered the observation group were divided into Q-wave group and non-Q-wave group after thrombolytic therapy, all patients were admitted to CCU, and immediately after admission and admission 8,16,24 , 48 and 72 hours, respectively, serum myocardial enzymology. Echocardiography was performed on 34 of the patients at 1 week and 6 weeks after myocardial infarction, and the left ventricular mass index was measured. Results The peak value of CPK in Q wave group (134758 ± 22033) IU, LV mass index in week 1 and week 6 were (23428 ± 9236) g · m -2, (271 ⑤ 52 ± 9312) g · m-2, were significantly higher than non-Q wave group, followed up for six months showed that the recent heart failure was also significantly higher than non-Q wave group. Conclusions Q wave appeared after thrombolysis, serum CPK peak value was higher than 500IU, LV mass index> 220g · m-2, which was the risk factor of left ventricular remodeling after acute myocardial infarction.