吸烟量对急性心肌梗死墓碑形ST段患者临床预后的影响

目的 :探讨吸烟量对急性心肌梗死 （AMI）早期墓碑形ST段抬高患者发病年龄、临床险恶特点和心电图特征的影响。方法 :分析心电图检测AMI早期墓碑形ST段抬高患者 5 9例中不吸烟 11例 ,少量吸烟 18例 ,大量吸烟 30例的临床特点和心电图某些指标。结果 :吸烟患者占 81% ,其中大量吸烟患者占 6 3%。吸烟者AMI发病年龄提前 ,前壁或复合前壁多见 ,并发泵衰竭 ,恶性心律失常、MI扩展发生比例大 （P <0 .0 5 ）。 1周内病死率高 （P <0 .0 1） ,心电图指标PTFv1负值增大 ,QTc间期延长、ST段抬高 /振幅加大和血清肌酸激酶显著升高 （P <0 .0 5 ）均以大量吸烟居多。吸烟量越大时间越长 ,AMI病死率相对危险度越高。结论 :吸烟能影响墓碑形ST段抬高AMI患者的近期预后。

Effect of smoking on short-term prognosis of ECG tombstoning of ST segment elevation

AIM: To study the effects of smoking on the age, clinical and ECG features of the AMI patients with early-stage tombstone ST segment elevation. METHO DS: Clinical and ECG features of the 59 AMI patients with early-stage tombstone ST segment elevation were determined, of whom 11 were non-smokers, 18, milder smokers and 30, heavy smokers. RESULTS: Of the 59 patients, smokers accounted for 81% and among the smokers heavy smokers accounted for 63%. Among the smokers, the age for the onset of AIM was getting younger and the infarcts in the tombstone were in the anterior wall (P< 0.05). The incidence of complications such as pump failure, infarct e xpansion, angina pectoris and malignant arrhythmia (P<0.05) and the first week death rate (P<0.01) were much higher than those of the non-smokers. Also, PTFv 1 value increased, ST segment was elevated and amplified, and the serum CK values grew significantly in the heavy smokers (P<0.05 or P<0.01). CONCLUSION : Smoking causes the tombstone ST segment elevation in AMI patients, which suggests a poor short-term prognosis.