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目的探讨伴对应导联ST段压低型急性心肌梗死(AMI)的早期(4周内)心功能(Killip分级)、死亡率及死亡原因。方法2001年1月~2005年12月住院,首次ST段抬高型AMI患者177例,前壁与下壁互为对应导联,以相邻2个或2个以上对应导联水平型或下斜型ST段压低≥0.1 mV为标准,分为ST段压低组(观察组)85例、及非ST段压低组(对照组)92例。结果对应导联压低组AMI引起的心力衰竭(泵衰竭)及心功能KillipⅢ~Ⅳ级死亡病例明显高于不伴有对应导联ST段压低组(P<0.05),同时泵衰竭是AMI死亡的主要原因。结论对应导联ST段压低型急性心肌梗死,这种心电变化并非生理性改变,而是心肌梗死面积扩大的表现,应早期实施冠脉再通,保护心功能,降低死亡率。
Objective To investigate the early (4 weeks) Killip classification, mortality and causes of death in patients with ST-segment depression-type acute myocardial infarction (AMI). Methods From January 2001 to December 2005, 177 patients with first ST segment elevation AMI were enrolled. The anterior wall and inferior wall corresponded to each other, with two or more adjacent leads horizontal or under Inclined ST-segment depression ≥0.1 mV as the standard, divided into ST segment depression group (observation group) 85 cases, and non-ST-segment depression group (control group) 92 cases. Results The mortality of heart failure (pump failure) and cardiac function Killip Ⅲ ~ Ⅳ caused by AMI were significantly higher than those without corresponding ST-segment depression (P <0.05), meanwhile pump failure was the cause of AMI death main reason. CONCLUSIONS: Corresponding lead ST-segment depression type AMI is not a physiological change, but an enlargement of myocardial infarction. Coronary recanalization should be performed early to protect heart function and reduce mortality.