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目的:寻找评估前壁或广泛前壁心肌梗死(AMI)时泵功能的无创、安全及客观方法。方法:应用12导联心电图机对64例首发前壁或广泛前壁AMI的患者,根据ST_(v3)抬高的形态分为凹陷割(Ⅰ型)、垂直型(Ⅱ型)和凸起型(Ⅲ型)3组。根据患者的临床特点,以及与Killip分级,溶栓治疗和预后的关系,分别进行3组间对比研究结果:(1)3型患者在发病年龄、性别、合并高血压、糖尿病史、∑ST、比较上均无统计学差异(P >0.05)、在梗死前发作心绞痛的比较,Ⅰ型与Ⅱ型,Ⅰ型与Ⅲ型,Ⅱ型与Ⅲ型之间均有显著性差异(均P<0.01或P<0.05 (2)Killip分级:经秩和检验Ⅰ型与Ⅲ型、Ⅱ型与Ⅲ型之间的患病率方面差别有显著性(均P<0.01),Ⅰ型与Ⅱ型之间无显著性差异(P>0.05)。(3)溶栓治疗:冠脉再通率在3组间未显示有统计学上的差异。(4)Ⅲ型者病死率多于其它两组。结论:ST_(v3)抬高的形态(三种类型)是判断前壁或广泛前壁AMI泵功能的一种客观、安全、无创和科学的方法。
PURPOSE: To search for a non-invasive, safe and objective method of assessing pump function in anterior or extensive anterior myocardial infarction (AMI). Methods: Sixty-four patients with AMI undergoing anterior or extensive anterior wall dissection were divided into two types according to ST_ (v3) elevation: type Ⅰ, type Ⅱ, and type Ⅱ (Type Ⅲ) 3 groups. According to the clinical characteristics of the patients and the relationship with Killip grading, thrombolytic therapy and prognosis, the results of the comparative study among the three groups were analyzed respectively: (1) Type 3 patients had significant differences in the age of onset, gender, history of hypertension, history of diabetes, There was no significant difference between the two groups (P> 0.05). There was significant difference in type Ⅰ and type Ⅱ, type Ⅰ and type Ⅲ, type Ⅱ and type Ⅲ of angina pectoris before infarction (all P <0.01 Or P <0.05. (2) Killip classification: The rank sum test showed that there was a significant difference in the prevalence between type I and type III, type II and type III (both P <0.01) There was no significant difference (P> 0.05). (3) Thrombolysis: The rate of coronary recanalization was not statistically different among the three groups. (4) The mortality of type Ⅲ was higher than that of the other two groups. : The ST_ (v3) elevation pattern (three types) is an objective, safe, noninvasive and scientific method of determining the function of anterior or extensive anterior AMI pumps.