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目的:应用简便、无创性的心电图探讨Q波型心机梗死(MI)后T波动态变化对左室收缩功能和心肌损害的影响。方法:对我院住院80例有Q波型急性心肌梗死(AMI),常规记录12导联心电图,观察异常Q波导联T波的动态变化。采用二维超声心动图(2D)、彩色心室壁动力分析(CK)和超声学定量(AQ)技术检测心室壁和左心室功能。结果:T波由倒置转为直立,即T正常化组的血浆CK峰值和心室壁运动得分指数(WMSI)明显低于T波持续倒置组(P<0.05),而左室短轴缩短率(FS)、峰值排空率(PFR)和射血分数(EF)显著高于T波持续倒置组(P<0.05),且T波正常化越早左心功能趋向于恢复越好。结论:心电图AMI异常Q波导联T波的动态变化,可作为评价左心功能和心肌损害程度的指标,对判定预后及指导治疗有重要的临床意义。
Objective: To investigate the effect of T wave dynamic changes on left ventricular systolic function and myocardial damage after simple myocardial infarction (MI) by simple and noninvasive electrocardiogram. Methods: 80 hospitalized patients with Q wave acute myocardial infarction (AMI), routine recording 12-lead ECG, observed abnormal wave Q-wave T wave dynamic changes. Ventricular wall and left ventricular function were detected by two-dimensional echocardiography (2D), colorimetric wall dynamic analysis (CK) and quantitative ultrasound (AQ). Results: The T wave changed from inverted to upright, that is, the peak value of plasma CK and the score of WMSI in T normalization group were significantly lower than those in continuous inversion T wave (P <0.05) FS, PFR and EF were significantly higher than those of continuous inversion of T wave (P <0.05), and the earlier the normalization of T wave, the better the left ventricular function tended to recover. Conclusion: The dynamic changes of T wave in abnormal Q waveguides of AMI can be used as an index to evaluate the extent of left ventricular dysfunction and myocardial damage, which has important clinical significance in judging prognosis and guiding treatment.