老年急性ST段抬高型心肌梗死心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ的相关性研究
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摘要
目的探讨老年急性ST段抬高型心肌梗死心电图Ⅲ级缺血与血清高敏肌钙蛋白T的相关性。方法回顾性选自于2015年6月至2017年6月期间收治的老年急性ST段抬高型心肌梗死患者91例,根据心电图分级:Ⅱ级心肌缺血组41例,Ⅲ级心肌缺血组50例。比较两组心肌梗死面积、心律失常发生情况、再梗死和病死情况、血清高敏肌钙蛋白Ⅰ水平变化,及心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ相关性。结果Ⅲ级心肌缺血组心肌梗死面积高于Ⅱ级心肌缺血组(P <0. 05);Ⅲ级心肌缺血组心律失常发生率(38. 00%)高于Ⅱ级心肌缺血组(17. 07%)(P <0. 05);Ⅲ级心肌缺血组再梗死和病死率高于Ⅱ级心肌缺血组(P <0. 05);Ⅲ级心肌缺血组血清高敏肌钙蛋白Ⅰ水平高于Ⅱ级心肌缺血组(P <0. 05);心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ呈线性正相关。结论老年急性ST段抬高型心肌梗死心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ密切相关,且心电图Ⅲ级缺血心肌梗死面积大、心律失常发生率高、再梗死和病死率高,具有重要临床研究价值。
Objective To investigate the correlation between electrocardiogramⅢ level ischemia and serum high sensitive troponin Ⅰ in elderly patients with acute ST segment elevation myocardial infarction( AMⅠ). Methods 91 cases of elderly patients with acute ST elevation myocardial infarction were selected in our hospital from June 2017 to June 2015,myocardial ischemia were classified according to the enzyme classification: 41 cases in grade Ⅱ myocardial ischemia group,50 cases grade Ⅲ myocardial ischemia group. The infarct size,arrhythmia,reinfarction and mortality,serum hypersensitive cardiac troponin Ⅰ levels,and the correlation between Ⅲ class ischemia and serum high sensitive troponin Ⅰ were compared between the two groups. Results The myocardial infarction area of myocardial ischemia group was higher than that of gradeⅡ grade Ⅲmyocardial ischemia group( P < 0. 05). The incidence of Ⅲ myocardial ischemia arrhythmia group( 38%) was higher than that of grade Ⅱ myocardial ischemia group( 17. 07%)( P < 0. 05). The reinfarction and mortality rate of Ⅲ myocardial ischemia group was higher than that of gradeⅡ myocardial ischemia group( P < 0. 05). The serum high sensitive troponin Ⅰ level of Ⅲ myocardial ischemia group was higher than that of theⅡ level of myocardial ischemia group( P < 0. 05). Grade Ⅲ ischemia and serum high sensitive troponin Ⅰ were linearly related. Conclusion The ECG Ⅲ ischemia in elderly patients with acute ST segment elevation myocardial infarction is positively related to serum high sensitive troponin Ⅰ. And the level of myocardial infarction of myocardial Ⅲ is high,the incidence of arrhythmia is high,reinfarction and mortality are high,which has important clinical research value.
Objective To investigate the correlation between electrocardiogramⅢ level ischemia and serum high sensitive troponin Ⅰ in elderly patients with acute ST segment elevation myocardial infarction( AMⅠ). Methods 91 cases of elderly patients with acute ST elevation myocardial infarction were selected in our hospital from June 2017 to June 2015,myocardial ischemia were classified according to the enzyme classification: 41 cases in grade Ⅱ myocardial ischemia group,50 cases grade Ⅲ myocardial ischemia group. The infarct size,arrhythmia,reinfarction and mortality,serum hypersensitive cardiac troponin Ⅰ levels,and the correlation between Ⅲ class ischemia and serum high sensitive troponin Ⅰ were compared between the two groups. Results The myocardial infarction area of myocardial ischemia group was higher than that of gradeⅡ grade Ⅲmyocardial ischemia group( P < 0. 05). The incidence of Ⅲ myocardial ischemia arrhythmia group( 38%) was higher than that of grade Ⅱ myocardial ischemia group( 17. 07%)( P < 0. 05). The reinfarction and mortality rate of Ⅲ myocardial ischemia group was higher than that of gradeⅡ myocardial ischemia group( P < 0. 05). The serum high sensitive troponin Ⅰ level of Ⅲ myocardial ischemia group was higher than that of theⅡ level of myocardial ischemia group( P < 0. 05). Grade Ⅲ ischemia and serum high sensitive troponin Ⅰ were linearly related. Conclusion The ECG Ⅲ ischemia in elderly patients with acute ST segment elevation myocardial infarction is positively related to serum high sensitive troponin Ⅰ. And the level of myocardial infarction of myocardial Ⅲ is high,the incidence of arrhythmia is high,reinfarction and mortality are high,which has important clinical research value.
引文
[1]Bulluck H,Go YY,Crimi G,et al.Defining left ventricular remodeling following acute ST-segment elevation myocardial infarction using cardiovascular magnetic resonance[J].J Cardiovasc Magn Reson,2017,19(1):26.
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[4]王小雨,姜春玉,李小莉,等.急性ST段抬高型心肌梗死心电图与冠状动脉造影的相关性研究[J].中国现代医生,2015,53(20):17-19.
[5]刘强,杨小梅,韩乾国.急性ST段抬高型心肌梗死患者心电图特征临床分析[J].医学与哲学,2015,36(16):32-34.
[6]王敏,郭延松.血浆DNA诊断早期急性ST段抬高型心肌梗死的研究[J].福建医药杂志,2016,38(1):1-4.
[7]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2010,38(8):675-690.
[8]王春杰.急性ST段抬高型心肌梗死患者的心电图特征分析[J].河南医学研究,2017,26(13):2788-2789.
[9]顾永林,郭俊林,蒋灵霓,等.急性ST段抬高性心肌梗死患者再灌注治疗后心肌损伤指标动态变化的价值[J].中国循证心血管医学杂志,2016,8(9):1119-1121.
[10]郭文玲,冯巧爱,吴磊,等.急性ST段抬高型心肌梗死早期再灌注治疗后心功能的评价[J].中西医结合心脑血管病杂志,2015,14(5):642-643.
[11]吴阳,张东辉,方卫华.心电图Ⅲ级缺血对急性ST段抬高型心肌梗死患者经皮冠状动脉介入术预后的预测意义[J].临床医学工程,2015,22(8):970-971.
[12]彭彬,倪爱华,张建新,等.急性ST段抬高型心肌梗死患者心电图3级缺血的易患因素及预后价值[J].中国医师杂志,2016,18(8):1223-1226.
[13]张浩,任国庆,孙文文,等.检测和肽素及肌钙蛋白I对急性非ST段抬高型心肌梗死的早期诊断价值[J].实用医学杂志,2014,30(19):3096-3099.
[14]张福伟,谢倩,陈漠水,等.急性ST段抬高型心肌梗死患者血清心锚重复蛋白与高敏C反应蛋白、肌酸激酶同工酶、心肌肌钙蛋白I相关性研究[J].中华危重症医学杂志(电子版),2017,10(2):82-86.
[2]Lloyd A,Steele L,Fotheringham J,et al.Pronounced increase in risk of acute ST-segment elevation myocardial infarction in younger smokers[J].Heart,2017,103(8):586-591.
[3]邓君.ST段抬高型心肌梗死超急性期的心电图特点分析[J].现代诊断与治疗,2015,24(1):177-179.
[4]王小雨,姜春玉,李小莉,等.急性ST段抬高型心肌梗死心电图与冠状动脉造影的相关性研究[J].中国现代医生,2015,53(20):17-19.
[5]刘强,杨小梅,韩乾国.急性ST段抬高型心肌梗死患者心电图特征临床分析[J].医学与哲学,2015,36(16):32-34.
[6]王敏,郭延松.血浆DNA诊断早期急性ST段抬高型心肌梗死的研究[J].福建医药杂志,2016,38(1):1-4.
[7]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2010,38(8):675-690.
[8]王春杰.急性ST段抬高型心肌梗死患者的心电图特征分析[J].河南医学研究,2017,26(13):2788-2789.
[9]顾永林,郭俊林,蒋灵霓,等.急性ST段抬高性心肌梗死患者再灌注治疗后心肌损伤指标动态变化的价值[J].中国循证心血管医学杂志,2016,8(9):1119-1121.
[10]郭文玲,冯巧爱,吴磊,等.急性ST段抬高型心肌梗死早期再灌注治疗后心功能的评价[J].中西医结合心脑血管病杂志,2015,14(5):642-643.
[11]吴阳,张东辉,方卫华.心电图Ⅲ级缺血对急性ST段抬高型心肌梗死患者经皮冠状动脉介入术预后的预测意义[J].临床医学工程,2015,22(8):970-971.
[12]彭彬,倪爱华,张建新,等.急性ST段抬高型心肌梗死患者心电图3级缺血的易患因素及预后价值[J].中国医师杂志,2016,18(8):1223-1226.
[13]张浩,任国庆,孙文文,等.检测和肽素及肌钙蛋白I对急性非ST段抬高型心肌梗死的早期诊断价值[J].实用医学杂志,2014,30(19):3096-3099.
[14]张福伟,谢倩,陈漠水,等.急性ST段抬高型心肌梗死患者血清心锚重复蛋白与高敏C反应蛋白、肌酸激酶同工酶、心肌肌钙蛋白I相关性研究[J].中华危重症医学杂志(电子版),2017,10(2):82-86.
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