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目的观察家兔急性心肌梗死早期缺血性J波的发生率、特点,及其与缺血性T波、ST段改变及室性心律失常的关系。方法取健康新西兰大耳白家兔40只随机等分为前降支组和回旋支组。①分析心电图缺血性J波的发生率;②缺血性J波出现的时间、导联及其与缺血性T波、ST段改变的关系;③分析缺血性J波与室性心律失常的关系。结果①前降支组缺血性J波发生率为20%(5/20),回旋支组为35%(7/20),两组间无统计学差异(p>0.05);②缺血性J波出现时间:7例缺血即刻(1s内)出现,5例缺血后稍延迟(1～15s)出现;出现导联:与缺血部位基本一致;与缺血性T波、ST段改变的关系:伴有T波增高(11例)或倒置(1例),两者接近同时出现。均伴有ST段抬高,出现时间早于ST段抬高(9例)或与ST段抬高同时出现(3例);③伴缺血性J波家兔室颤和猝死的发生率显著高于无缺血性J波家兔(p<0.05)。结论缺血性J波是急性心肌梗死超急性期不容忽视的心电图改变,是发生恶性室性心律失常的预警指标。
Objective To observe the incidence and characteristics of early ischemic J waves in rabbits with acute myocardial infarction and its relationship with ischemic T wave, ST segment changes and ventricular arrhythmia. Methods Forty New Zealand white rabbits were randomly divided into anterior descending branch group and circumflex branch group. Â ’£ analysis of the incidence of ischemic J wave ECG; â’¡ ischemic J wave appeared in time and lead and its relationship with ischemic T wave, ST segment changes; â’ £ analysis of ischemic J wave and ventricular arrhythmias Abnormal relationship. Results ① The incidence of ischemic J waves was 20% (5/20) in the anterior descending group and 35% (7/20) in the circumflex group, with no significant difference between the two groups (p> 0.05) Sexual J wave appearance time: 7 cases of ischemia immediately (within 1s), 5 cases of a slight delay after ischemia (1 ~ 15s) appear; leads: the same with the ischemic site; and ischemic T wave, ST Segmental changes in the relationship: accompanied by T wave increased (11 cases) or inverted (1 case), both close to simultaneous. All had ST-segment elevation as early as ST segment elevation (9 cases) or ST-segment elevation (3 cases); ③ The incidence of ventricular fibrillation and sudden death in rabbits with ischemic J wave was significantly Higher than non-ischemic J wave rabbits (p <0.05). Conclusions The ischemic J wave is an electrocardiogram change that can not be ignored in the hyperacute stage of acute myocardial infarction and is an early warning indicator of malignant ventricular arrhythmia.