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目的分析急性脑血管病合并急性心肌梗死(AMI)的心电图改变以提高诊断的准确性。方法对1567例急性脑血管病患者发病24h内行颅脑CT,标准导联心电图(ECG)及心肌酶学检查。结果1567例急性脑血管病患者ECG呈AMI改变者38例,经查肌钙蛋白CtnI确诊AMI38例其中前壁5例;前间壁5例;下壁7例;下壁及前壁1例;下壁及右心室4例,非Q波型心肌梗死16例。发现AMI组中出现异常Q波伴ST-T改变,前壁或前间壁AMI时rv1>rv2>rv3及SV3下降支出现切迹或挫折,非Q波型心肌梗死ST段呈下斜型或下垂型下移>0.1mV有重要意义。结论急性脑血管意外合并AMI的心电图改变有重要的诊断价值。
Objective To analyze the changes of electrocardiogram in acute cerebrovascular disease complicated with acute myocardial infarction (AMI) so as to improve the diagnostic accuracy. Methods A total of 1567 patients with acute cerebrovascular disease underwent brain CT, standard ECG and myocardial enzymology examination within 24 hours. Results Among 1567 patients with acute cerebrovascular disease, 38 were AMI with ECG changes, 38 were diagnosed as AMI by cTnI, 5 were anterior wall, 5 anterior wall, 7 inferior wall, 1 inferior wall and anterior wall. 4 cases of wall and right ventricle, 16 cases of non-Q wave myocardial infarction. Found that AMI group with abnormal Q wave with ST-T changes, anterior wall or anterior wall AMI rv1> rv2> rv3 and SV3 descending branch of cut or setback occurred, ST-segment non-Q-wave myocardial infarction was downward oblique or sagging Type down> 0.1mV is important. Conclusion There is an important diagnostic value of ECG changes in acute cerebrovascular accident combined with AMI.