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正常心电图T波的形态为非对称性,上升支波度小,波顶钝圆,降支陡直,正常T波振幅上限各家意见不一。多数认为,标准肢导联T>2mm,单极肢导联T>5mm,单极胸导T>20mm,称为T波增高。笔者综合有多种原因可致T波增高,并讨论其鉴别诊断。 一、缺血性心脏病 高T见于心肌梗塞或非梗塞性心肌缺血。 (一)心肌梗塞 在出现急性心梗的特征性QR8和ST—T变化之前,可能有对称或非对称高T出现。即所谓“超急性T波”。这是急性心梗的最早期表现。其可以发生某些特定导联上。如:前壁心梗的心前导联,下壁心梗的Ⅱ、Ⅲ、AVF导联上。该高T伴有ST段抬高或压低或等电位。该高T
T wave of normal ECG T-shape asymmetry, rising branch of the wave, blunt round, descending branch steep, normal T-wave amplitude of the various opinions vary. Most believe that the standard limb lead T> 2mm, unipolar lead T> 5mm, unipolar chest guide T> 20mm, known as T wave increased. The author has a variety of reasons can lead to T wave increased, and discuss the differential diagnosis. First, ischemic heart disease seen in high T myocardial infarction or non-ischemic myocardial infarction. (A) Myocardial Infarctions Symmetric or asymmetric high-T appearance may occur prior to the characteristic QR8 and ST-T changes in acute MI. The so-called “hyperacute T wave.” This is the earliest manifestation of acute MI. It can happen on some specific leads. Such as: anterior myocardial infarction anterior cardioplegia, inferior myocardial infarction Ⅱ, Ⅲ, AVF lead. The high T with ST segment elevation or depression or equipotential. The high T