标题：缺血性J波预测ST段抬高心肌梗死恶性室性心律失常的价值

      作者：陈宋璋，陈允祥，潘少奕
    (普宁市人民医院内科，广东 普宁 515300)

      卷次： 2014年25卷11期

      【摘要】 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。

      【关键词】 ST段抬高心肌梗死；缺血性 J波；恶性心律失常

      【中图分类号】 R542.2+.2 【文献标识码】 A 【文章编号】 1003—6350（2014）11—1582—03


Clinical efficacy of ischemic J-wave in predicting malignant ventricular arrhythmia in patients with
ST-segment elevation myocardial infarction.
CHEN Song-zhang, CHEN Yun-xiang, PAN Shao-yi. Department of
Internal Medicine, The People's Hospital of Puning, Puning 515300, Guangdong, CHINA

【Abstract】 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.

      【Key words】 ST-segment elevation myocardial infarction; Ischemic J-wave; Malignant ventricular arrhythmia
·论 著·