动态心电图对急性心肌梗塞早期特殊演变的探讨

我们用动态心电图观察了５例急性心肌梗塞患者早期心电图演变过程，３例为正常规律性演变，如从Ｔ波高大、ＳＴ段异常抬高以及病理性Ｑ波形成等演变过程。另外发现２例为特殊的演变过程，即在急性心肌梗塞典型心电图形成稳定以前出现一段短时间内病理性Ｑ波与正常ＱＲＳ波反复交替出现的特殊演变过程。这种特殊演变是随着临床症状的加重与好转而相应出现的，是心肌反复严重缺血所致。反复缺血具有积累效应，也就是说，各次缺血之间心肌的缺血性损伤未能完全恢复，时轻时重，最后导致心肌坏死。这一早期反复演变在临床治疗上应引起高度的重视。

STUDY ON THE EARLY SPECIAL EVOLUTION OF AMI BY HOLTER ECG

Early special evolution of acute myocardial infarction in five patients wasstudied by Holter ECG. Regular evolution was found in three cases e.g. high and large Twave,extraordinary raised ST section and pathologic Q wave. The other two had shown ashort time special evolution which was alterant appearance between pathologic Q wave andnormal QRS wave before the acute myocardial infarction occured.This special evolution ap-peared or not was according to the clinical symptoms serious or easy.That is to say,myocar-dial ischemia occured repeatedly would result in myocardial infarction. Therefore,the earlyspecial evolution shoud be paid more attention in clinical diagnosis and treatment.