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作者以201例接受溶栓治疗的首次急性心梗(AMI)患者为对象,评价 Q 波形成的时间及其预后意义。开始溶栓治疗3小时内141例(70%)已有 Q 波,开始溶栓治疗3小时后至出院前31例(16%)形成 Q 波,29例(14%)出院时仍无 Q 波。与无 Q 波型 AMI患者相比,Q 波型 AMI 患者反映心肌损伤的实验室指标、住院病患率和死亡率均较高。结合 Q 波形成时间评价上述指标,表明 Q 波延迟形成者和非 Q 波型 AMI 者的预后无显著差异。与早期(≤3h)形成 Q 波者相比,Q波延迟形成或非 Q 波型 AMI 者的肌酸磷酸激酶峰值较低(均值661～1081对1251～1541IU,P=0.05),放射性核素法左室喷血分数较高(54±11%对47±13%,P<0.01),
The 201 patients with acute myocardial infarction (AMI) treated with thrombolytic therapy were included in this study to evaluate the timing of Q wave formation and its prognostic significance. There were Q waves in 141 cases (70%) within 3 hours after initiating thrombolytic therapy, Q waves in 31 cases (16%) after thrombolytic therapy started 3 hours before discharge and 29 cases (14%) left Q wave . Compared with patients without Q-wave AMI, Q-wave AMI patients with laboratory indicators of myocardial damage, hospitalization rates and mortality were higher. Combined with the Q wave formation time evaluation of the above indicators, indicating that the Q waves delayed formation and non-Q wave AMI prognosis was no significant difference. Compared with early (≤3h) Q wave formation, peak creatine phosphokinase activity was lower in patients with Q-wave delayed or non-Q-wave AMI (mean 661-1081 vs 1251-1541 IU, P = 0.05), and radionuclide Law left ventricular ejection fraction was higher (54 ± 11% vs 47 ± 13%, P <0.01)