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目的 :观察急性前壁心肌梗死 (AAMI)患者急性期心电图ST段抬高形态与心肌梗死面积和左心收缩功能的关系。方法 :根据入院时心电图V3 导联ST段抬高的不同形态将 6 2例首次住院的AAMI患者分为 3组 :A组 (ST段呈弓背向下抬高 ) 18例 ,B组 (ST段呈斜坡状抬高 ) 2 7例 ,C组 (ST段呈弓背向上抬高 ) 17例 ;测定3组患者血清肌酸磷酸激酶 (CPK)峰值和左室射血分数 (LVEF)。结果 :A组患者血清CPK峰值明显低于B组和C组 ,差异有统计学意义 (P值分别 <0 .0 5、<0 .0 1) ,B组和C组比较 ,CPK峰值有显著性差异 (P <0 .0 5 ) ;A组患者LVEF明显高于B组和C组 ,差异有统计学意义 (P值分别 <0 .0 5、<0 .0 1) ,B组和C组比较 ,LVEF亦有显著性差异 (P <0 .0 5 )。结论 :AAMI早期V3 导联ST段抬高的不同形态可以反映心肌缺血性损伤的严重程度 ,对预测梗死心肌范围和心脏功能有一定的价值。
OBJECTIVE: To observe the relationship between ST segment elevation and myocardial infarction size and left ventricular systolic function in patients with acute anterior myocardial infarction (AAMI) during acute phase. Methods: Sixty-two first-time hospitalized patients with AAMI were divided into three groups according to the different forms of ST-segment elevation of electrocardiogram V3 lead: 18 patients in group A (ST-segment elevation), 18 patients in group B 27 cases in group S, 17 cases in group C (ST-segment elevation), and the peak of serum creatine phosphokinase (CPK) and left ventricular ejection fraction (LVEF) were measured in 3 groups. Results: The peak value of serum CPK in group A was significantly lower than that in group B and C (P <0.05, <0.01, respectively). The peak value of CPK in group B and group C was significant (P <0.05). The LVEF of group A was significantly higher than that of group B and C (P <0.05, <0.01), group B and C LVEF also had significant difference (P <0.05). CONCLUSIONS: The different forms of ST segment elevation in the early lead of AAMI can reflect the severity of myocardial ischemic injury and have some value in predicting myocardial infarction size and cardiac function.