心肌梗塞后伴发室性心律失常的程度与心室晚电位的关系

目的：观察心肌梗塞后伴发的室性心律失常与心室晚电位之间的关系。方法：采用高频心电检测仪记录４１例心肌梗塞后病人的体表心室晚电位，并于心室晚电位检查前或后一周内行２４小时动态心电图检查，用于评价室性心律失常的程度。结果：室性早搏Ｌｏｗｎ分级大于或等于Ⅲ级的病人和Ｌｏｗｎ分级Ⅰ Ⅱ级的病人比较，其ＱＲＳＴ、Ｄ４０显著延长而Ｖ４０明显降低（Ｐ＜０．０５及Ｐ＜０．０１）。Ｌｏｗｎ分级大于或等于Ⅲ级组的心室晚电位阳性检出率要显著高于Ｌｏｗｎ分级Ⅰ Ⅱ级组和未检出室性早搏组。Ｌｏｗｎ分级Ⅰ Ⅱ级组和未检出室性早搏组比较，二者的心室晚电位阳性检出率无显著差异。结论：室性早搏的严重程度反映了心肌梗塞后心肌缺血或心脏电生理改变的程度。

The Relationship between the Degree of Ventricular Arrhythmia and Ventricular Late Potentials after Myocardial Infarction

Objective:The aim of this study was to observe the relationship between the different degree of ventricular arrhythmia and ventricular late potentials(VLPs) after myocardial infarction.Methods:The body surface VLPs were recorded by a high freqency electrocardiogram detection instrument in 41 patients with myocardial infarction,and the 24 hours ambulatory electrocardiogram monitoring was used to evaluate the degree of ventricular arrhythmia before or after VLPs within a week.Results:The QRS T and D 40 were markly prolonged and V 40 was markly decreased in patients with Lowns ventricular premature beats(VPBs) class≥Ⅲ (contrasted to Lowns class Ⅰ Ⅱ,P<0.05 and P<0.01,respectively).The positive rate of detecting VLPs in the group with Lowns class≥Ⅲ was markly higher than the groups with Lowns class Ⅰ Ⅱ and without VPBs.The difference in the positive rates of detecting VLPs between the group with Lowns class Ⅰ Ⅱ and the group without VPBs was non significant.Conclusion: The severe degree of VPBs reflects the degree of myocardial ischemia or heart electrophysiological alterations resulted from myocardial infarction.