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目的 通过急性ST段抬高型心肌梗死(STEMI)心电图QRS波群变化进行缺血分级,探讨心电图缺血与血清高敏肌钙蛋白I(hs-cTnI)的关系.方法 根据入院心电图将120例STEMI患者分为Ⅲ级缺血组(QRS波终末变形)81例(67.5%)和Ⅱ级缺血组(QRS波终末不变形)39 例(32.5%),两组均行冠脉造影及hs-cTnI检测.比较两组冠脉血管病变发生情况与血清hs-cTnI的关系.结果 ① Ⅲ级缺血组中男68例(83.95%),女13例(16.05%);Ⅱ级缺血组中男27例(69.23%),女12例(30.77%),两组性别比较差异有统计学意义(P<0.05);② Ⅲ级缺血组患者左前降支病变发生率高于Ⅱ级缺血组(P<0.05),Ⅱ级缺血组患者左回旋支病变发生率高于Ⅲ级缺血组(P<0.001);③ 两组血清hs-cTnI测定为偏态分布,差异有统计学意义(Z=-2.78,P<0.006);④ Ⅱ级缺血组hs-cTnI浓度低于Ⅲ级缺血组,差异有统计学意义(P<0.05).结论 STEMI心电图Ⅲ级缺血与血清hs-cTnI浓度有关.“,”Objective Based on the ischemia classification according to the change of QRS complex in ECG of patients with acute ST segment elevation myocardial infarction(STEMI), to explore the relationship between electrocardiographic ischemia and serum hs-cTnI.Methods According to their ECGs on admission, 120 STEMI patients were divided into grade Ⅲ ischemia group(with QRS terminal distortion;n=81, accounting for 67.5%) and grade Ⅱis chemia group(without QRS terminal distortion;n=39, accounting for 32.5%).Coronary angiographic examination and hs-cTnI inspection were performed on both of the two groups.The relationship between the circumstances of coronary obstruction and serum hs-cTnI was compared between two groups.Results (i) In grade Ⅲ ischemia group, there were 68 males(83.95%) and 13 females(16.05%);in grade Ⅱ ischemia group, there were 27 males(69.23%) and 12 females(30.77%).There was statistically significant difference in sex between the two groups(P<0.05).(ii) The incidence of lesion in left anterior descending artery among patients of grade Ⅲ ischemia group was higher than that in the other group(P<0.05), however, the incidence of lesion in left circumflex artery was lower(P<0.001).(iii) The measured serum hs-cTnI was characterized by skew distribution with statistically significant difference(Z=-2.78, P<0.006).(iv) Compared two groups of patients with hs-cTnT level , grade Ⅱ ischemia is lower than the levels grade Ⅲ ischemia, the difference was statistically significant(P<0.05).Conclusion Grade Ⅲ ischemia in ECG of STEMI patients is associated with the concentration of serum hs-cTnI.