摘要目的 分析急性心肌梗死超急性期心电图有或无J波的临床意义及预后改变.方法 对河南省濮阳市中医院心内科及急诊科近5年收住院的90例急性心肌梗死患者的临床资料进行回顾性分析.根据心电图将其分为J波组25例(27.8％)和无J波组65例(72.2％),比较两组间住院期间室性心律失常发生率、猝死率、预后左室射血分数.结果 J波组/无J波组室性心律失常发生率、猝死率、预后左室射血分数分别为17例(68.0％)/27例(41.5％)；2例(8.0％)/2例(3.1％)；(49±8)％/(52±8)％；室性心律失常发生率J波组明显高于无J波组(P＜0.05)；猝死发生率J波组明显高于无J波组(P＜0.05)；预后左室射血分数值J波组与无J波组相比差异无统计学意义(P＞0.05).结论 急性心肌梗死超急性期心电图可出现J波,也可无J波,无J波者更常见.出现J波者提示心电活动更具有不稳定性,易发生室性心律失常,并可导致较高的猝死发生率,但对预后心功能并未造成明显影响.

abstractsObjective To analyze the clinical significance and prognosis of the electrocardiogram with or without J wave in patients with acute myocardial infarction in super-acute phase.Methods The clinical data of 90 patients with acute myocardial infarction in our hospital in recent five years were retrospectively analyzed.According to the electrocardiogram,the patients were divided into J wave group of 25 patients (27.8％),and no J wave group of 65 patients (72.2％).The incidence rate of ventricular arrhythmias,the sudden death rate and left ventricular ejection fraction (LVEF) between the two groups were compared.Results In J wave group,17 cases (68.0％) occured ventricular arrhythmia,no J wave group has 27 cases (41.5％),the ventricular arrhythmia incidence was higher in J wave group (P ＜ 0.05).J wave group had 2 cases(8.0％) of sudden death,no J wave group had 2 cases (3.1％),the sudden death rate of J wave group was significantly higher than that of no J wave group (P ＜ 0.05).The LVEF was(48.9 +8.1)％ in J wave group and (51.7 +7.8)％ in no J wave group,there was no significant difference between J wave group and no J wave group in prognosis of LVEF (P ＞0.05).Conclusions The electrocardiogram of acute myocardial infarction in the super-acute phase can appear J wave,can also be no J wave,but no J wave is more common.J wave indicates ECG activities has more instability,and more prone to ventricular arrhythmia,and leads to a higher incidence of sudden cardiac death,but has no significant influence on prognosis of cardiac function.