CAJ | 학술논문

目的：探讨缺血性J波对ST段抬高心肌梗死(STEMI)患者发生恶性室性心律失常的预测价值。方法选择本院于2010年7月至2013年7月期间确诊的STEMI患者263例，将入院时经心电图检查未记录到缺血性J波者列为对照组，共210例，将在首次心电图检测中记录到缺血性J波者列为观察组，共53例。观察两组患者入院48 h和住院期间的恶性心律失常发生率；比较两组之间及观察组中患者的QT、QTd、Tp-Te值。结果观察组入院48 h恶性心律失常发生率为28.3%，明显高于对照组的10.5%，其差异具有统计学意义(P<0.05）。观察组患者住院期间恶性心律失常发生率为32.1%，明显高于对照组的16.2%，其差异具有统计学意义(P<0.05）。观察组患者入院48 h内发生恶性心律失常患者的QTd和Tp-Te值分别为(99±22) ms和(142±25) ms，均高于无该症状者的(72±14) ms和(104±21) ms，其差异均具有统计学意义(P<0.05)。观察组的QTd、Tp-Te值分别为(91±24) ms和(130±32) ms，均高于对照组的(61±17) ms和(97±22) ms，其差异均具有统计学意义(P<0.05)。结论 J波可作为急性STEMI患者发生恶性室性心律失常的预测指标，如结合QTd、Tp-Te值能进一步提高其预测价值。
목적：탐토결혈성J파대ST단태고심기경사(STEMI)환자발생악성실성심률실상적예측개치。방법선택본원우2010년7월지2013년7월기간학진적STEMI환자263례，장입원시경심전도검사미기록도결혈성J파자렬위대조조，공210례，장재수차심전도검측중기록도결혈성J파자렬위관찰조，공53례。관찰량조환자입원48 h화주원기간적악성심률실상발생솔；비교량조지간급관찰조중환자적QT、QTd、Tp-Te치。결과관찰조입원48 h악성심률실상발생솔위28.3%，명현고우대조조적10.5%，기차이구유통계학의의(P<0.05）。관찰조환자주원기간악성심률실상발생솔위32.1%，명현고우대조조적16.2%，기차이구유통계학의의(P<0.05）。관찰조환자입원48 h내발생악성심률실상환자적QTd화Tp-Te치분별위(99±22) ms화(142±25) ms，균고우무해증상자적(72±14) ms화(104±21) ms，기차이균구유통계학의의(P<0.05)。관찰조적QTd、Tp-Te치분별위(91±24) ms화(130±32) ms，균고우대조조적(61±17) ms화(97±22) ms，기차이균구유통계학의의(P<0.05)。결론 J파가작위급성STEMI환자발생악성실성심률실상적예측지표，여결합QTd、Tp-Te치능진일보제고기예측개치。
Objective To investigate the clinical efficacy of ischemic J-wave in predicting malignant ventric-ular arrhythmia in patients with ST-segment elevation myocardial infarction. Methods Two hundred and sixty-three patients with ST-segment elevation myocardial infarction, diagnosed in our hospital from July 2010 to July 2013, were enrolled in this study. Among them, 53 patients with ischemic J-wave in electrocardiogram were allocated into obser-vation group, and the other 210 patients without the ischemic J-wave in electrocardiogram were allocated into control group. The incidence of malignant arrhythmia at 48 h after hospitalization or during the hospitalization in all the pa-tients were observed. And the QT, QTd and Tp-Te were compared between the two groups. Results The incidence of malignant arrhythmias in the observation group at 48 h after hospitalization was 28.3%, which was statistically signifi-cantly higher than 10.5%, the incidence in the control group (P<0.05). During hospitalization, the incidence of malig-nant arrhythmias in the observation group was statistically significantly higher than that in the control group (32.1%vs 16.2%, P<0.05). Within the hospitalization time of 48 h, in the observation group, the QTd and Tp-Te in the patients with malignant arrhythmia were statistically significantly higher than those without malignant arrhythmia [(99±22) ms vs (72±14) ms and (142±25) ms vs (104±21) ms, P<0.05]. And the QTd and Tp-Te in the observation group were statis-tically significantly higher than those in the control group [(91±24) ms vs (61±17) ms, and (130±32) ms vs (97±22) ms, P<0.05]. Conclusion The J-wave is a potential predictor of malignant ventricular arrhythmias in acute STEMI pa-tients, and it will get better predictive effect if combined with QTd and Tp-Te.