医学研究与教育 ›› 2018, Vol. 35 ›› Issue (1): 25-30.DOI: 10.3969/j.issn.1674-490X.2018.01.005

• 临床医学 • 上一篇    下一篇

应激性心肌病与急性前壁心肌梗死的心电图特征比较

胡昕1,曹志然2,徐放3   

  1. 1.河北大学附属医院心电图室, 河北 保定 071000;
    2.河北大学医学院, 河北 保定 071000;
    3. 河北大学附属医院重症医学科, 河北 保定 071000
  • 收稿日期:2018-01-05 出版日期:2018-02-25 发布日期:2018-02-25
  • 通讯作者: 曹志然(1963—),女,河北景县人,教授,硕士,硕士生导师,主要从事感染免疫研究。E-mail: caozhiran@163.com
  • 作者简介:胡昕(1984—),女,河北保定人,主治医师,主要从事心电图研究。 E-mail: 107884906@qq.com

  • Received:2018-01-05 Online:2018-02-25 Published:2018-02-25

摘要: 目的 研究和比较心电图在诊断应激性心肌病与急性前壁心肌梗死的临床价值,进一步提高早期诊断的准确率。方法 对2种疾病患者的心电图进行比较分析。结果 2种疾病心电图特征存在较明显差异,在ST段抬高导联分布上,应激性心肌病下壁导联分布比例明显高于急性前壁心肌梗死,而在V1导联上明显少于急性前壁心肌梗死;急性前壁心肌梗死的-aVR导联ST段抬高明显少于应激性心肌病;应激性心肌病中病理性Q波发生率明显低于急性前壁心肌梗死,且具有暂时性、可逆性之特征,不同于急性前壁心肌梗死;大部分急性前壁心肌梗死存在镜面改变,而在应激性心肌病中几乎不存在。结论 应激性心肌病和急性前壁心肌梗死的心电图不同表现对于早期鉴别诊断具有一定价值。

关键词: 应激性心肌病, 急性前壁心肌梗死, 心电图

Abstract: Objective To study and compare the clinical value of ECG in the diagnosis of irritable cardiomyopathy and acute anterior wall myocardial infarction, and further improve the accuracy of early diagnosis. Methods The electrocardiograms of patients with two diseases were compared and analyzed. Results The results indicated that there were more obvious differences in electrocardiogram(ECG)characteristics between the two diseases on the distribution of ST segment elevation lead, lead wall under stress cardiomyopathy distribution ratio was significantly higher than that of anterior wall acute myocardial infarction, and significantly less than in V1 lead acute anterior wall myocardial infarction; Acute anterior wall myocardial infarction -aVR leads ST segment elevation was significantly less than that of stress cardiomyopathy. The incidence of pathological Q wave in irritable cardiomyopathy was significantly lower than that of acute anterior wall myocardial infarction, and it had the characteristics of transience and reversibility, which was different from acute anterior wall myocardial infarction. Most of the acute anterior wall myocardial infarction had a mirror change, and there was little in stress cardiomyopathy. Conclusion Stress cardiomyopathy electrocardiogram(ECG)and acute anterior wall myocardial infarction different performance have a certain value in the early differential diagnosis.

Key words: stress cardiomyopathy, acute anterior wall myocardial infarction, electrocardiogram(ECG)

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