Abstract
目的 探讨前壁急性心肌梗塞(AMI)ST段呈墓碑形抬高的临床意义.方法68例前壁AMI分为ST段呈墓碑形抬高组(A组,19例)和ST段呈常态形抬高组(B组,49例),比较两组患者的心电图(ECG)特点及临床资料.结果(1)A组出现对应导联ST段下移13例(68.42%),B组14例(28.57%)(P＜0.05);(2)A组QT间期离散度(QTd)(69.98±18.26ms)明显高于B组(60.11±16.94ms)(P＜0.01);(3)室性心律失常A组11例(57.89%),B组9例(18.36%)(P＜0.05);(4)A组血清磷酸肌酸激酶(CK)及其同工酶(CK-MB)峰值为(2317.1±657.4)u/L和(264.4±127.9)u/L,明显高于B组的(1892.2±548.9)u/L和(137.6±88.5)u/L(分别为P＜0.005和P＜0.01):(5)冠脉造影A组17例(89.47%)呈多支病变,B组30例(61.22%)(P＜0.01).结论AMI后ST段呈墓碑形抬高患者梗死面积大,室性心律失常发生率高,冠状动脉病变严重。
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