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心肌梗塞的心电图表现,包括心室复波的三种改变:深宽Q波、ST段上升或变形、以及两肢对称的尖锐倒置T波。一般认为,深宽Q波(病理性Q波)最具有特异性,提示心肌坏死。但近年来许多作者发现,病理性Q波作为心肌梗塞的诊断指标,并非都是完全可靠的。本文讨论当今对Q波的认识。一、心肌梗塞的Q波冠脉阻塞后,心肌缺血性损害始于心内膜下,透过室壁向心外膜下层发展。随着时间的推移,可逆性损害变为不可逆性;缺血持续时间愈长,不可逆性损害的心肌细胞数量愈大。有人将此称为“波前坏死”现象。人类此现象可能持续6小时左右。
ECG manifestation of myocardial infarction, including three changes in ventricular complex wave: deep wide Q wave, ST segment rise or deformation, and sharp symmetrical sharp inverted T wave. Generally believed that deep wide Q wave (pathological Q wave) the most specific, suggesting myocardial necrosis. However, in recent years, many authors have found that pathological Q wave is not entirely reliable as a diagnostic indicator of myocardial infarction. This article discusses today’s Q wave awareness. First, Q-wave myocardial infarction coronary artery occlusion, myocardial ischemic injury began in the endocardium, through the ventricular wall to the epicardial sub-layer development. With time, reversible damage becomes irreversible; the longer the duration of ischemia, the greater the number of irreversible damage to the cardiomyocytes. Some people call this “wavefront necrosis” phenomenon. This phenomenon in humans may last about 6 hours.