不同年龄组急性心肌梗死患者心室晚电位发生情况分析

【目的】探讨心室晚电位（VLP）在不同年龄组急性心肌梗死（AMI）患者的阳性率差别。方法]中国医科大学附属第一医院心血管内科2011年2～8月收治的AMI患者357例：其中高龄老年（≥80岁）AMI组32例，老年（60～79岁）AMI组154例、非老年（34～59岁）AMI组171例进行VLP检测。【结果】高龄老年AMI组32例患者中，VLP阳性23例（71．9％）；老年AMI组154例患者中，VLP阳性82例（53．2％）；非老年AMI组171例患者中，VLP阳性74例（43．3％），三组VLP阳性率差别有统计学意义（x^2=9．87，P〈0．01）。VLP阳性179例患者中，发生恶性室性心律失常（包括室颤、室速）的27例（15．1％），VLP阴性178例患者中，发生恶性室性心律失常的11例（6．2％），差异有统计学意义（x^2=7．44，P〈0．01）。结论]：IAMI患者随着年龄的增高，VLP阳性率明显上升。VLP阳性患者恶性心律失常发生率明显高于VLP阴性患者。尽早进行心电监护并检测VLP对预防和避免老年AMI恶性室性心律失常有重要意义。

Analysis of the Incidence of Ventricular Late Potential in Different Age Groups of Patients with Acute Myocardial Infarction

Objective] To explore the differences of positive rate of ventricular late potential（VLP） among dif- ferent age groups of patients with acute myocardial infarction（AMI）. Methods] VLP of 357 AMI patients admitted to cardiology department of our hospital from Feb. 2011 to Aug. 2011 were measured. All patients were divided into high-elderly AMI group（ n =32, ≥80 years old）, elderly AMI group（ n =154, 60-79 years old） and non-elderly AMI group（ n = 171, 34-59 years old）. Results] The positive rate of VLP in high-elderly AMI group, elderly AM1 group and non-elderly AMI group were 71.9%（23 cases）, 53.2%（82 cases） and 43.30/00（74 cases） respective- ly, and there were significant differences among 3 groups（x2 = 9.87, P d0.0IL The incidence of malignant ventric- ular arrhythmia（ventrieular fibrillation and tachycardia） in VLP-positive patients was 15.1 % （27 cases）, while that in VLP-negative patients was 6.2 % （11 cases）, and there was significant difference （X2 = 7.44, P 〈0.01）. Conclusion]The positive rate of VLP in AMI patients obviously increases with the age. The incidence of malignant ventricu- lar arrhythmia in VLP-positive patients is obviously higher than that in VLP-negative patients. Electrocardiogram mo- nitoring as early as possible and the detection of VLP is very important to prevent and avoid malignant ventricular ar- rhythmia in elderly patients with AMI.