摘要
目的分析急性心肌梗死（AMI）超急性期的心电图。方法58例经院外急救随后转入急诊室治疗的考虑AMI的患者，男37例，女21例，年龄56．7（35～82）岁，接受全导联的心电图追踪捕记，后经心肌酶谱检查或冠脉造影最终确诊为急性心梗。分析其心电图特点。结果58例AMI病例中，急性前壁24例（41．4％），前间壁15例（25．9％），下壁10例（17．2％），前壁合并下壁9（15．5％）。AMI超急性期的心电网中均未见异常Q波出现。ST段斜上型抬高38例（占65．5％），T波高尖、增宽41例（70．7％）。有4例初始心电图大致正常，呈假性正常化现象（6．9％）。这些表现仅持续数小时。结论在AMI超急性期的心电图中，往往没有典型的病理性Q波、损伤型ST段抬高和缺血性T波改变，而表现为T波增高或高尖、ST段抬高（常为斜上型）、或R波的增高或降低，也可能无明显改变（假性正常化）。认识这些变化有助于对提高院外诊断，减少误诊。
objective To investigate the electrocardiographic characteristics of acute myocardial infarction （AMI） at the super-acute phase. Methods Fifty-eight AMI patients, 37 males and 21 females, aged 56.7 （35-82）, underwent pre-hospital first aid and then treatment in emergency room and all received dynamic electrocardiography. The diagnosis of AMI was confirmed by myocardial zymography and/or coronary angiography. The electrocardiographic characteristic was analyzed. Results Of the 58 cases, 24 （41.3%） were diagnosed as with acute anterior myocardial infarction, 15 （25.8%） with anteroseptal infarction, 10 （17.2%） with inferior myocardial infarction, and 9 （17.2） with anterior myocardial infarction complicated with inferior myocardial infarction. No abnormal Q wave was seen in all leads. Thirty-eight cases （65.5%）showed oblique and upward ST segment elevation, 41 cases （70.6%） showed high, sharp, and broad T wave. Four cases showed pseudo-normalization in the initial electrocardiogram. Such manifestations lasted several hours. Conclusion Typical pathological Q wave, injury-pattern ST segment elevation, and ischemic T wave changes are not seen in the ECG of AMI at the super-acute phase. Oblique and upward ST segment elevation, sharp, and broad T wave; changes in R wave amplitude, and pseudo-normalization help raise the pre-hospital diagnostic rate and decrease the misdiagnosis rate of AMI.
出处
《中国急救复苏与灾害医学杂志》
2010年第2期140-141,146,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
急性心肌梗死
超急性期心电图
Acute myocardial infarction （AMI）
Super-acute phase
Electrocardiogram
