电镜及免疫标记髓过氧化物酶检测对急性白血病分型诊断的意义

目的 比较电镜髓过氧化物酶(MPO)、免疫标记抗髓过氧化物酶抗体(抗MPO抗体)、光镜过氧化物酶(POX)对急性白血病分型诊断的敏感性和特异性。方法 对38例初诊的急性白血病患者，APAAP法检测MPO抗体及电镜MPO细胞化学染色。结果 光镜POX阳性组抗MPO及电镜MPO染色均呈阳性，光镜POX阴性组22例中有5例抗MPO抗体阳性，6例电镜MPO染色阳性。结论 抗MPO法及电镜化染对急性白血病分类中髓系特征的判断具有敏感性好，特异性高的优点，个别病例电镜MPO反应较免疫标记MPO抗体更为有效和敏感。     

血浆髓过氧化物酶水平对急性心肌梗死患者预后的影响

炎症和氧化应激在急性心肌梗死（AMI）的发生、发展过程中发挥了重要的作用。目前有多种标记物能被用来判断AMI的预后，本研究观察髓过氧化物酶（MPO）对AMI的影响和预测价值。     

急性心肌梗死患者介入治疗术后髓过氧化物酶的早期变化及意义

目的 观察急性心肌梗死患者介入治疗术后早期髓过氧化物酶（MPO）的动态变化,初步探讨术后MPO水平对经皮冠状动脉介入（PCI）治疗患者住院期间主要不良心血管事件（MACE）发生情况的预测价值。方法选取发病在12 h内、初次因胸痛就诊的急性心肌梗死患者68例,根据是否行PCI治疗分为支架组（46例）和保守组（22例）。并选取冠状动脉血管正常的15例患者作为正常对照组。分别于术前（T0）及术后30 min、4 h、12 h、24 h（T1～T4）抽取外周肘静脉血,用酶联免疫吸附法检测MPO和高敏C反应蛋白（hs-CRP）的水平,记录支架组住院期间MACE的发生情况。结果 支架组和保守组术前的MPO和hs-CRP水平无差异（P>0.05）,但均高于正常对照组（P<0.01）。术后支架组与保守组MPO和hs-CRP的表达均有所增加。支架组MPO、hs-CRP水平分别在T2、T4时达高峰,均高于术前（P<0.01）。保守组MPO和hs-CRP水平呈缓慢上升趋势,均于T4时升至最高。支架组MPO、hs-CRP峰值均显著高于保守组（P<0.01）。正常对照组MPO和hs-CRP水平均无动态变化（P>0.05）。住院期间支架组有9例发生MACE,经受试者工作特征曲线分析,T2时的MPO水平可预测院内MACE的发生情况（曲线下面积为0.823,界值为792.850 μg/L,灵敏度88.9%,特异度70.3%,P＝0.003）。结论 MPO是急性心肌梗死患者PCI术后早期炎症反应的敏感指标,在PCI术后早期就已明显升高并达高峰;PCI术后4 h的MPO水平对院内MACE的发生具有一定的预测价值,且优于术前。     

老年胸痛患者血MPO、BNP水平变化及临床意义

目的观察老年胸痛患者血髓过氧化物酶（MPO）和脑钠肽（BNP）水平变化,并探讨临床意义。方法因胸痛入院老年患者115例,冠状动脉造影结果显示急性冠状动脉综合征70例（ACS组）、稳定型心绞痛23例（SA组）、造影正常22例（C组）。术前均抽取静脉血,ELISA法检测血清MPO、血浆BNP。结果与C组比较,ACS组、SA组血MPO、BNP水平均明显升高（P均〈0.05）,ACS组血MPO、BNP水平高于SA组（P均〈0.01）。与术前比较,术后ACS组血MPO、BNP水平均降低（P均〈0.01）。结论老年ACS患者血MPO、BNP水平明显升高,检测二者有助于老年胸痛患者的危险分层。     

ST段抬高型心肌梗死患者全身免疫炎症指数对无复流发生的影响

目的：ST段抬高型心肌梗死（ST-segment elevation myocardial infarction,STEMI患者无复流的发生率高,同时无复流又与炎症密切相关。本研究探索全身免疫炎症指数（systemic immune inflammatory index,SII）对STEMI患者无复流发生的影响。方法：回顾性研究2020年1月至2023年1月,于西安交通大学第一附属医院诊断为STEMI患者546例。根据SII的四分位数分为四组：组1(SII <518.8)、组2(518.8≤SII<1 096.2),组3(1 096.2≤SII<2 217.6),组4(SII≥2217.6)。研究的主要终点是无复流的发生。通过多元Logistic回归分析探究SII对无复流的影响,结果使用比值比（OR）和95%置信区间（CI）表示。使用亚组分析探究在不同亚组中SII对无复流结局的影响。绘制限制性立方样条函数（RCS）直观反映SII与无复流之间的关系。结果：随着SII的增高,患者无复流发生率显著增高[组1 vs.组2 vs.组3 vs.组4:14(10.2%)vs. 20...     

髓过氧化物酶早期识别急性冠状动脉综合征的临床价值

目的:探讨髓过氧化物酶(MPO)浓度与急性冠状动脉综合征(ACS)的关系及其早期识别ACS的临床价值。方法: 采用酶联免疫吸附法测定血浆MPO浓度。 结果: ACS组患者血浆MPO浓度明显升高,与正常对照组、稳定型心绞痛（SAP）组比较差异有统计学意义（P<0.05）。SAP组血浆MPO浓度高于正常对照组（P<0.05）。血浆MPO浓度与中性粒细胞、肌酸激酶同工酶及受试组呈正相关,与年龄、高敏感C反应蛋白、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油、天冬氨酸氨基转移酶、空腹血糖、乳酸脱氢酶、红细胞计数、血小板计数无相关性。依据临床表现和冠状动脉造影,临床诊断ACS 41例, 非ACS组37例,绘制ROC曲线（A=0.927,P=0.000）。MPO诊断界值为212.59 μg/L,MPO≥212.59 μg/L为阳性,诊断为ACS,MPO<212.59 μg/L为阴性,诊断非ACS。临床诊断ACS 41例中,MPO阳性39例,阴性2例,非ACS组37例中,MPO阳性5例,阴性32例,MPO诊断ACS灵敏度为95%,特异度为86%,准确度为91%,假阴性率(漏诊率)为5%,假阳性率(误诊率)为14%,阳性预测值为89%,阴性预测值为94%。本法与临床诊断ACS方法进行Kappa一致性检验,Kappa系数值为0.819,P=0.000,说明两种方法的吻合程度具有统计学意义,两法一致性较好。采用Logistic逐步回归,筛选出有统计学意义的影响因素为MPO 、低密度脂蛋白胆固醇和肌酸激酶同工酶,建立预测模型,MPO预测ACS总正确率为95%,提示MPO对ACS具有较高的预测价值。结论: MPO能有效地早期识别ACS。     

ANGPTL4免疫脂质体对急性肺损伤小鼠的治疗作用

目的探讨ANGPTL4免疫脂质体对转染脂多糖(lipopolysaccharide,LPS)诱发的急性肺损伤(acute lung injury,ALI)小鼠,肺损伤的影响。方法采用逆相蒸发法制备ANGPTL4基因表达质粒与抗CD31抗体偶联的免疫脂质体;LPS诱发急性肺损伤小鼠模型;观察经ANGPTL4免疫脂质体转染的急性肺损伤小鼠的肺部炎症因子肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)水平和中性粒细胞活化标志物髓过氧化物酶(myeloperoxidase,MPO)表达的变化,以及小鼠肺组织病理变化和肺血管通透性的改化。结果 ANGPTL4免疫脂质体可以有效增加小鼠肺内ANGPTL4的表达;进而降低ALI小鼠肺泡灌洗液中的TNF-α、IL-6水平和MPO的表达;降低ALI小鼠肺组织湿干比和肺泡灌洗液蛋白浓度,减轻肺组织病变程度。结论 ANGPTL4免疫脂质体能有效减轻LPS诱导的ALI小鼠的肺部炎症损伤反应。     

外周血髓过氧化物酶对急性ST段抬高型心肌梗死患者急诊PCI术后不良心血管事件的影响

目的 探讨外周血髓过氧化物酶(MPO)对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)术后不良心血管事件(MACE)的影响.方法 选择88例确诊为STEMI且急诊行PCI的患者作为研究对象,随访1年,根据其是否发生MACE分为发生组与未发生组,比较两组临床特征的差异,同时分析MPO与MACE发...     

改良骨髓涂片免疫酶标ABC法的建立及其临床应用

目的：建立一种准确性高、简便易行、成本低的急性白血病（AL）免疫分型方法。方法：对常用的骨髓涂片免疫酶标ABC法进行改进，检测29例AL患者CD3、CD14、CD19、CD33的表达，同时将其检测结果与流式细胞术法检测结果进行比较。用已建立的改良骨髓涂片免疫酶标ABC法检测55例AL的免疫学表型，并与形态学分型进行比较。结果：改良骨髓涂片免疫酶标ABC法较传统骨髓涂片免疫酶标ABC法敏感性高，结果更准确；视野更加清晰，背景染色低；与流式细胞术法检测的4种分化抗原阳性表达百分比之间差异无统计学意义（P〉0．05），结果具有同等意义。本研究建立的方法可用于白血病的免疫学分型，可对形态学诊断起必要的补充作用，尤其是对形态学难以分类的白血病。结论：改良骨髓涂片免疫酶标ABC法是一种准确性高、简便易行、低成本的AL免疫分型方法，可在基层医院推广用于临床。     

高碳酸血症对急性肺损伤保护作用及机制探讨的实验研究

目的探讨高碳酸血症对急性肺损伤模型的保护作用及可能的机制。方法24只新西兰兔按随机数字表法分为对照组、治疗组、预防组，每组8只。采用脂多糖静脉注射复制肺损伤模型，观察3组兔血流动力学、血气指标的变化；检测肺组织湿／干重（W／D）比、光镜、肺损伤组织学定量评价指标（IQA）来评估肺脏的损伤程度。通过对肺组织中髓过氧化物酶（MPO）、丙二醛（MDA）及血清和支气管肺泡灌洗液（BALF）中白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF—α）浓度及中性粒细胞凋亡率的测定，阐明高碳酸血症对肺损伤保护的可能机制。结果（1）治疗组、预防组在模型形成后平均动脉压、心率、动脉血二氧化碳分压（PaCO2）、动脉血氧分压／吸入气氧浓度（PaO2／FiO2）分别为（79±6）mm Hg（1mmHg=0．133kPa）、（180±10）次／min、（99±13）mmHg、250±26，（80±9）mmHg、（181±12）次／min、（95±11）mmHg、241±56，与对照组[（66±10）mmHg、（139±13）次／min、（31±4）mmHg、182±35]比较差异有统计学意义（t值分别为4．05、26．32、5．36、28．15、12．54、11．07、16．13、12．36。P均分别〈0．05、0．01）；（2）治疗组、预防组W／D、NPO、MDA分别为1．98±0．28、1．87±0．30、（6．1±1．6）U／g、（5．8±1．5）U／g、（20±5）mg／L、（19±4）mg／L，与对照组[2．43±0．26、（9．0±1．3）U／g、（36±8）mg／L]比较差异有统计学意义（t值分别为11．07、24．46、2．35、9．63，12．34、25．32，P分别〈0．05、0．01）；（3）治疗组、预防组血清和BALF中IL-8、TNF—α、中性粒细胞凋亡率分别为（50±8）ng／ml、（103±49）ng／ml、（94±16）ng／ml、（44±9）ng／ml、（38±9）％、（56±5）％、（49±7）ng／ml、（96±50）ng／ml、（91±14）ng／ml、（39±6）ng／ml、（39±10）％、（55±10）％，与对照组[（91±43）ng／ml、（177±60）ng／ml、（162±15）ng／ml、（67±7）ng／ml、（19±7）％、（43±7）％]比较差异有统计学意义（t值分别为7．12、5．55、7．30、3．93、13．08、8．00，P分别〈0．05、0．01）；（4）各组血清及BALF中IL-8、TNF—α与中性粒细胞凋亡率呈负相关（r值分别为-0．73、-0．72、-0．52、-0．64、-0．73、-0．56、-0．57、-0．78、-0．69、-0．75、-0．82、-0．84，P均〈0．05）。结论高碳酸血症对急性肺损伤具有保护作用，对血流动力学无明显影响。     

Clinical utility of cryptococcal antigen detection in transthoracic needle aspirate by lateral flow assay for diagnosing non-HIV pulmonary cryptococcosis: A multicenter retrospective study

Lateral flow immunoassay (LFA) detection of cryptococcal capsular polysaccharide antigen (CrAg) is reported to be the most rapid and convenient laboratory method for diagnosing cryptococcosis. Its clinical diagnostic use, however, is not well studied. We retrospectively analyzed the data from 97 patients with suspected pulmonary cryptococcosis (PC) at 2 tertiary care centers. CrAg in both serum and lung aspirate specimens were examined by LFA. We divided the patients who were diagnosed with PC into group I, patients positive for CrAg in both the serum and lung aspirate, and group II, patients positive for CrAg in the lung aspirate but not in the serum. We analyzed the differences in imaging distribution, morphological characteristics, and concomitant signs between the 2 groups. Of all 97 patients, 47 were diagnosed with PC. Lung aspirates were positive for CrAg in 46/47 patients with PC (sensitivity 97.9%, specificity 100%, positive predictive value = 100%, negative predictive value = 98%). There were no false positive results in the noncryptococcosis patients, revealing a diagnostic accuracy of 99%. Serum CrAg tests were positive in 36/47 patients with PC (sensitivity 76.6%, specificity 100%, accuracy 88.7%, positive predictive value = 100%, negative predictive value = 82%). Chest imaging data showed a statistically significant greater number of single lesions in group II than in group I (P < .05). More lesions accompanied by halo signs were showed in group I (P < .01), whereas more accompanied by pleural stretch signs were found in group II (P < .01). The LFA-positive rate of CrAg in lung aspirate samples was higher than that of the serum samples, especially in patients with single pulmonary lesion or in those accompanied by pleural stretch. The direct measurement of CrAg in lung aspirate is a rapid, useful alternative diagnostic method for PC confirmation.     

急性心肌梗死直接PCI术前早期应用替罗非班的有效性和安全性研究

目的观察早期应用替罗非班在急性心肌梗死（AMI）经皮腔内冠状动脉介入治疗（PCI）中的临床价值。方法152例急性ST段抬高型心肌梗死（STEMI）行急诊PCI术患者随机分为试验组和对照组,均于发病12h内行急诊PCI术。试验组一旦确诊STEMI即静脉给予负荷量（10μg／kg）盐酸替罗非班,5min内静脉推注,继而以0．15g·kg^-1·min^-1微量泵持续泵人36h;对照组在导丝通过或球囊预扩张后在5min内静脉推注10μg／kg盐酸替罗非班,继而以0．15／μg·kg^-1·min^-1微量泵持续泵人36h。观察两组PCI术后即刻梗死相关得血管（IRA）心肌梗死溶栓（TIMI分级）血流情况和心肌灌注分级情况,术后30d内出血并发症及主要不良心脏事件（MACE）的发生情况,术后7d和30d心脏超声左室舒张末期内径（LVEDD）和左室射血分数（LVEF）。结果试验组与对照组相比,并不能改善术后冠状动脉造影血流分级,但可改善心肌灌注分级,且差异有统计学意义;术后30d,试验组的LVEDD显著小于对照组,而LVEF则显著大于对照组,且差异有统计学意义;术后30d,试验组的主要不良心脏事件发生率显著少于对照组,且差异有统计学意义;两组出血并发症发生率差异并没有统计学意义。结论在急性心肌梗死介入治疗中,早期应用盐酸替罗非班并不能改善造影血流分级,但可改善心肌灌注分级,从而保护心功能,并且是安全的。     

急性心肌梗死与心率变异的临床观察

为探索急性心肌梗死时心率变异性指标变化规律,测定４４例急性心肌梗死患者的心率变异性时域指标并与５０例正常人进行对比。结果显示：急性心肌梗死患者心率变异明显低于对照组（Ｐ〈０．０５）;前臂心肌梗死者低于非前臂心肌梗死者,且随着心肌酶的升高、心功能下降相应下降,发生心脏事件者明显低于不发生心脏事件者。提示急性心肌梗死早期心率变异性指标明显下降,表明心脏自主神经功能失调。     

急性心肌梗塞病人运动康复治疗的临床分析

目的 :了解康复运动对急性心肌梗塞后 2 8天病人的运动贮量及心脏功能的影响。方法 :将 2 0例急性心肌梗塞病人随机分为运动康复组与对照组 ,治疗组应用 Med Graphics心肺运动功能仪进行康复治疗 2 0次。对照组给予心肌梗塞常规治疗。结果 :治疗组峰值 V· O2 (耗氧量 )、 AT(无氧阈 )、 RPP(二项乘积 )值均较对照组明显升高。结论 :急性心肌梗塞后病人进行康复运动能提高其运动贮量和功能     

Safety and effectiveness of enoxaparin following fibrinolytic therapy: Results of the Acute Myocardial Infarction (AMI)-QUEBEC registry

BACKGROUND:

Previous randomized controlled trials and meta-analyses demonstrated the superior efficacy of enoxaparin (ENOX) over unfractionated heparin (UFH) in patients with ST segment elevation myocardial infarction (STEMI). The external validity of randomized controlled trials may be limited by selective inclusion of patients who are younger and healthier than the ‘real-life’ population.

OBJECTIVE:

To evaluate the safety and effectiveness of ENOX compared with UFH in unselected STEMI patients.

METHODS:

The safety and effectiveness of ENOX and UFH were compared in STEMI patients who received fibrinolytic therapy at 17 Quebec hospitals in 2003.

RESULTS:

A total of 498 STEMI patients received systemic anticoagulation, with ENOX and UFH administered in 114 and 384 patients, respectively. There were no differences in baseline characteristics between the two patient groups. The rates of in-hospital major adverse cardiac or cerebral events were 11.4% in the ENOX group compared with 14.0% in the UFH group (P=0.51). In-hospital death or nonfatal reinfarction occurred in 7.9% of patients who received ENOX compared with 9.9% of patients who received UFH (P=0.52). Major bleeding occurred in 4.4% of patients who received ENOX versus 6.0% in patients who received UFH (P=0.51).

INTERPRETATION:

There was no significant difference in the rates of in-hospital adverse events in the ENOX group compared with the UFH group, when used in the real-life context. Larger observational studies may further confirm the safety, effectiveness and optimal duration of the administration of ENOX in unselected STEMI patients treated with fibrinolysis.     

小剂量倍他乐克对老年急性心肌梗死后心室晚电位干预的研究

目的　探讨小剂量倍他乐克对老年急性心肌梗死 (AMI)后心室晚电位 (VLP)长期干预的作用。方法　将 1 68例老年 AMI后 VLP阳性患者随机分为两组 ,86例干预组患者服倍他乐克 6.2 5～ 2 .5 mg/次 ,2次 /d,82例对照组常规服消心痛。结果　小剂量倍他乐克干预后能使 VLP转阴 (74/86) ,使 SA- ECG的 TD- QRS、LAS较治疗前缩短 ,RMS增加 (P<0 .0 1 ) ,并有效控制室性心律失常发生。结论　小剂量倍他乐克长期干预能使老年 AMI患者 VLP转阴 ,同时又避免大剂量快速用药所致副作用。老年 AMI患者出现 VL P阳性如无明显β-阻滞剂禁忌 ,应首选小剂量倍他乐克长期治疗。     

20-year trends in clinical characteristics, therapy and short-term prognosis in acute myocardial infarction according to presenting electrocardiogram: the MONICA/KORA AMI Registry (1985-2004)

Objectives. To examine the extent to which evidence‐based beneficial therapy is applied in practice, whether this is changing over time and is associated with improved outcomes. Background. Randomized trials have proved efficacy of several treatments for acute myocardial infarction (AMI) with ST‐elevation (STEMI), non‐ST‐elevation (NSTEMI) and bundle branch block (BBB). Design and Setting. We prospectively examined all 6748 consecutive patients with AMI aged 25–74 years hospitalized in the study region’s major clinic stratified into four time‐periods: 1985–1989 (n = 1622), 1990–1994 (n = 1588), 1995–1999 (n = 1450) and 2000–2004 (n = 2088). Results. The increase in numbers of AMI in the last period was mainly, but not exclusively driven by NSTEMI cases. Evidence‐based pharmacological therapy increased steeply over time. Invasive procedures increased mainly in the last period with percutaneous coronary intervention and coronary artery bypass graft performed in 30% and 15% in 1998 and 66.0% and 22%, respectively, in 2004. In‐hospital complications and 28‐day‐case fatality decreased significantly from period 1 to period 4 in all patients with AMI. Marked reductions in 28‐day‐case fatality were mostly seen in BBB patients during the last period (25.3% vs. 10.3%, P < 0.001). Of interest, the odds in 28‐day‐case fatality reduction was diminished after correction for recanalization therapy (from 0.35, 95% CI: 0.16–0.74 to 0.52, 95% CI: 0.19–1.45). Conclusions. Over the past 20 years, there were substantial changes in pharmacological and interventional therapies in AMI accompanied by reductions in in‐hospital complications and 28‐day‐case fatality in all infarction types with marked reductions in 28‐day‐case fatality in BBB patients. The latter observation may mainly be because of the increased use of interventional therapy.     

心肌损伤标志物对心肌梗死与心绞痛的鉴别诊断效率评价

目的评价几种心肌损伤标志物用于急性心肌梗死(AMI)与心绞痛的鉴别诊断效率。方法选择解放军第306医院2002年11月至2004年11月收治的住院患者188例,其中AMI组92例,心绞痛组96例。肌钙蛋白I(TnI)和肌红蛋白(Myo)测定用化学发光法,肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)用酶动力连续监测法,超敏C-反应蛋白(hs-CRP)用增强胶乳免疫浊度法。采用受试者操作特性曲线(ROC)分析曲线下面积和敏感度、特异性。结果AMI发生≤6h的ROC曲线下的面积依次为Myo0·92、TnI0·92、CK0·81、CK-MB0·81、AST0·78、hs-CRP0·73、LDH0·70、HBDH0·65;AMI发生>6h依次为TnI0·93、AST0·86、CK-MB0·84、CK0·80、Myo0·76、HBDH0·72、LDH0·70、hs-CRP0·56;AMI发生≤6h的敏感性和特异性TnI0·87和0·90、Myo0·96和0·78、CK0·83和0·67、CK-MB0·65和0·82、AST0·69和0·77、LDH0·64和0·73、HBDH0·71和0·65、hs-CRP0·64和0·82。阳性似然比最高为TnI8·8,阴性似然比最低为Myo0·05。结论AMI与心绞痛鉴别诊断效率依次为TnI、Myo、CK-MB、CK;Myo在AMI发作6h以后的诊断效率降低,AST、LDH、HBDH仍有意义。     

Improving the ECG classification of inferior and lateral myocardial infarction by inversion of lead aVR

OBJECTIVE—To assess whether the use of inverted lead aVR (?aVR) would improve the classification of acute inferior or lateral myocardial infarction presenting with ST elevation.DESIGN—Observational study. The presence of ? 1 mm ST elevation in lead ?aVR (derived by manual assessment of ST depression in conventional lead aVR) was determined by a single investigator, blinded to patient outcome.PATIENTS—173 consecutive patients with chest pain for ? 12 hours and ST elevation of ? 1 mm in inferior leads (II, III, aVF) or lateral leads (I, aVL, V5, V6), excluding those with anterolateral ST elevation.MAIN OUTCOME MEASURE—Incidence of ST elevation in lead ?aVR in patients with inferior or lateral ST elevation, or both.RESULTS—ST elevation in lead ?aVR was present in 25 of 136 patients (18%) with inferior but no lateral ST elevation (indicating greater superior involvement) and in three of 11 patients (27%) with lateral but no inferior ST elevation (indicating greater inferior involvement). ST elevation in lead ?aVR bridged the gap between inferior and lateral ST elevation in 15 of 25 (60%) patients with inferior and lateral chest lead (V5/V6) ST elevation, and in all patients with inferior and lateral limb lead (I/aVL) ST elevation. The presence of ST elevation in lead ?aVR was associated with a larger infarct size as defined by median peak creatine kinase on serial sampling: 1780 v 987  mmol/l; p = 0.021.CONCLUSIONS—Use of lead ?aVR improves the ECG classification of acute inferior or lateral acute myocardial infarction and thus may be useful as part of the routine 12 lead ECG assessment of such patients.     

心电图对急性心肌梗塞PCI术后的诊断价值

目的探讨体表心电图对于急性心肌梗塞PCI术后的诊断应用价值。方法对27例确诊为急性心肌梗塞患者PCI术后行追踪体表心电图及超声心动图的检测。结果 ST段早期回落至及T波早期倒置组较ST段未回落组及T波未倒置组心功能恢复好。结论体表心电图不仅是诊断心肌梗塞,判断部位和范围、分期的重要依据,且心肌梗塞PCI术后,通过观察ST段和T波的动态演变对于临床分析、指导治疗和判断预后都有着重要指导意义。