心肌梗死超急性期患者10例的ST段的变化分析

目的:探讨心肌梗死超急性期患者ST段抬高的变化特点。方法:回顾性分析10例心肌梗死患者的临床资料，根据患者预后情况分为病死组5例和好转组5例，比较2组患者心电图和血清标志物检查结果。结果:病死组中3例心电图ST段呈“墓碑型”抬高；2例呈“巨R波型”抬高；好转组患者心电图ST段呈“斜长型”1例，“新月型”2例，“水平型”1例，“弓背型”1例，2组差异有统计学意义（P<0.01）。2组患者平均发病5 h后，心肌酶谱发生改变，2组肌酸磷酸激酶同工酶和心肌肌钙蛋白T水平差异均无统计学意义（P>0.05）。结论:心肌梗死超急性期患者多出现ST段抬高现象，“墓碑型”和“巨R波型”ST段抬高可能是心肌严重损伤的表现，病死率较高。

Analysis of ST segment change in patients with myocardial infarction during hyperacute period

Objective:To investigate the change characteristics of ST segment elevation in patients with myocardial infarction during hyperacute period. Methods:The clinical data of 10 patients with myocardial infarction were retrospectively analyzed,and the patients were divided into the death group and improvement group according to the prognosis(5 cases each group). The examination results of electrocardiogram and serum marker between two groups were compared. Results:The "tombstone type" ST segment elevation in 3 cases and "giant R-wave type" ST segment elevation in 2 cases in death group were found,the"plagioclase type" in 1 case,"crescent type" in 2 cases,"horizontal type" in 1 case and "arched type" in 1 case in improvement group were identified,and the difference of which between two groups was statistical significance(P<0. 01). The myocardial enzyme in two groups changed after 5 h of the onset, and the difference of the levels of CK-MB and cTnT between two groups were not statistical significance(P>0. 05). Conclusions:The ST segment elevation phenomenon is found in most patients with acute myocardial infarction,the “tombstone type” and “giant R-wave type” ST segment elevation maybe the serious manifestations of cardiac injury,the mortality of patient is high.