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目的 :探讨急性心肌梗死 (AMI)后T波的动态变化与心肌损害和左室功能之间的关系。方法 :6 2例前壁Q波型AMI患者 ,其中T波由倒置转为直立 ,即T波正常化 39例 (<3个月 6例 ,>3～ 6个月 14例 ,6～12个月 19例 ) ;T波持续直立 5例 ;T波持续倒置 18例。AMI后常规记录 12导联心电图。采用二维超声心动图、彩色心室壁动力分析和超声学定量 (AQ)技术检测室壁运动和左心室收缩功能状况。结果 :T波持续倒置组血浆肌酸激酶 (CK)峰值和心室壁运动得分指数 (WMSI)明显高于T波直立组 ,而左心室短轴缩短率 (FS)、峰值排空率 (PER)和射血分数 (EF)显著低于T波持续直立组 ;且T波正常化越早左心功能恢复得越好。T波持续直立组血浆CK峰值、WMSI均高于T波直立各亚组和T波持续倒置组 ,而FS、EF和PER均显著低于各亚组。结论 :AMI后 12个月异常Q波导联的T波动态变化能用于评价左心室的局部和整体收缩功能
Objective: To investigate the relationship between T wave dynamic changes and myocardial damage and left ventricular function after acute myocardial infarction (AMI). Methods: Sixty-two cases of anterior Q-wave AMI patients, including T wave from upside down to upright, that is, T wave normalization in 39 cases (<3 months in 6 cases,> 3 to 6 months in 14 cases, 6 to 12 Month 19 cases); T wave continued erect in 5 cases; T wave continued inversion in 18 cases. 12-lead electrocardiogram was routinely recorded after AMI. Two-dimensional echocardiography, colorimetric wall dynamic analysis and quantitative ultrasound (AQ) were used to detect wall motion and left ventricular systolic function. Results: Plasma creatine kinase (CK) peak and wall motion score index (WMSI) were significantly higher in T wave continuous inversion group than those in T wave vertical group, while left ventricular short axis shortening (FS) and peak emptying rate (PER) And ejection fraction (EF) were significantly lower than the T wave continuous erection group; and T wave normalization the sooner left heart function recovered better. The peak values of plasma CK in T wave continuous erection group were higher than that in T wave vertical subgroup and T wave continuous inversion group, while FS, EF and PER were significantly lower than those in subgroups. CONCLUSION: The dynamic changes of T wave in abnormal Q-wave guide at 12 months after AMI can be used to evaluate the local and global systolic function of left ventricle