缺血性J波预测ST段抬高心肌梗死恶性室性心律失常的价值

目的探讨缺血性J波对ST段抬高心肌梗死（STEMI）患者发生恶性室性心律失常的预测价值。方法选择本院于2010年7月至2013年7月期间确诊的STEMI患者263例,将入院时经心电图检查未记录到缺血性J波者列为对照组,共210例,将在首次心电图检测中记录到缺血性J波者列为观察组,共53例。观察两组患者入院48 h和住院期间的恶性心律失常发生率;比较两组之间及观察组中患者的QT、QTd、Tp-Te值。结果观察组入院48 h恶性心律失常发生率为28.3%,明显高于对照组的10.5%,其差异具有统计学意义（P〈0.05）。观察组患者住院期间恶性心律失常发生率为32.1%,明显高于对照组的16.2%,其差异具有统计学意义（P〈0.05）。观察组患者入院48 h内发生恶性心律失常患者的QTd和Tp-Te值分别为（99±22）ms和（142±25）ms,均高于无该症状者的（72±14）ms和（104±21）ms,其差异均具有统计学意义（P〈0.05）。观察组的QTd、Tp-Te值分别为（91±24）ms和（130±32）ms,均高于对照组的（61±17）ms和（97±22）ms,其差异均具有统计学意义（P〈0.05）。结论 J波可作为急性STEMI患者发生恶性室性心律失常的预测指标,如结合QTd、Tp-Te值能进一步提高其预测价值。

Clinical efficacy of ischemic J-wave in predicting malignant ventricular arrhythmia in patients with ST-segment elevation myocardial infarction

Objective To investigate the clinical efficacy of ischemic J-wave in predicting malignant ventricular arrhythmia in patients with ST-segment elevation myocardial infarction. Methods Two hundred and sixty-three patients with ST-segment elevation myocardial infarction, diagnosed in our hospital from July 2010 to July 2013, were enrolled in this study. Among them, 53 patients with ischemic J-wave in electrocardiogram were allocated into observation group, and the other 210 patients without the ischemic J-wave in electrocardiogram were allocated into control group. The incidence of malignant arrhythmia at 48 h after hospitalization or during the hospitalization in all the patients were observed. And the QT, QTd and Tp-Te were compared between the two groups. Results The incidence of malignant arrhythmias in the observation group at 48 h after hospitalization was 28.3%, which was statistically significantly higher than 10.5%, the incidence in the control group（P〈0.05）. During hospitalization, the incidence of malignant arrhythmias in the observation group was statistically significantly higher than that in the control group（32.1% vs16.2%, P〈0.05）. Within the hospitalization time of 48 h, in the observation group, the QTd and Tp-Te in the patients with malignant arrhythmia were statistically significantly higher than those without malignant arrhythmia （99±22） ms vs（72±14） ms and（142±25） ms vs（104±21） ms, P〈0.05]. And the QTd and Tp-Te in the observation group were statistically significantly higher than those in the control group （91±24） ms vs（61±17） ms, and（130±32） ms vs（97±22） ms,P〈0.05]. Conclusion The J-wave is a potential predictor of malignant ventricular arrhythmias in acute STEMI patients, and it will get better predictive effect if combined with QTd and Tp-Te.