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目的:探讨早期T波倒置和ST段回落指标对评估急性心肌梗死(AMI)预后的意义。方法:ST段抬高AMI患者86例,均接受再灌注治疗,ECG监测T波、ST段变化及超声心动图检测左室重构(LVRM),临床观察住院时间、住院期间、0.5a内心功能及病死率;以ECG早期T波倒置和(或)ST段回落分组,对比分析两项指标单用与联用判断预后的敏感度、特异度及约登指数。结果:单用ECG早期T波倒置或ST段回落指标对LVRM、心衰、病死率等判断的敏感度及特异度无统计学差异(P>0.05),但两项指标联用时敏感度、约登指数均明显提高。结论:联用ECG早期T波倒置和ST段回落两项指标较单用能提高对AMI预后的预测,有助于临床干预的抉择。
Objective: To investigate the significance of early T wave inversion and ST segment depression index in assessing the prognosis of acute myocardial infarction (AMI). Methods: Eighty-six AMI patients with ST elevation were enrolled in this study. All patients underwent reperfusion therapy, T-wave, ST-segment changes and echocardiography were used to detect left ventricular remodeling (LVRM). The hospital stay, hospitalization, And mortality were compared. The sensitivity, specificity and Youden index were compared between the two indexes for the prognosis of T-wave inversion and / or ST segment regression. Results: There was no significant difference in the sensitivity and specificity of single ECG in early T wave inversion or ST-segment depression index on LVRM, heart failure and fatality rate (P> 0.05) The index was significantly improved. Conclusions: The combination of ECG early T-wave inversion and ST-segment fallback can improve the prediction of AMI prognosis, which is helpful for the choice of clinical intervention.