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目的探讨吸烟对ST段抬高急性心肌梗死(ST segment elevating acute myocardial infarction STEMI)心室电风暴对临床预后影响。方法选择2000年1月~2012年12月间,住院初发STEMI并发心室电风暴119例,根据吸烟量区分不吸烟(从不吸烟或偶尔吸烟平均≤1支/d,或完全停止吸烟≥3年者为不吸烟)(Ⅰ组)11例;少量吸烟(把规律吸烟持续2~10支/d,为少量吸烟)(Ⅱ组)39例;大量吸烟(≥11支/d为大量吸烟)(III组)69例。分析其心电图和临床近期高危预后。结果心电图PTFv1负值增大、ST段抬高振幅、QTc间期延长等指标明显异常,Ⅰ组患者发生率9.2%、Ⅱ组患者发生率32.8%,III组患者发生率最高58.0%,并以复合前壁AMI及临床并发低血压、住院病死率等发生率高(P<0.01)。结论认为吸烟指数与STEMI心室电风暴心电图异常和临床近期预后险恶密切相关。
Objective To investigate the effect of smoking on the clinical prognosis of ST segment elevating acute myocardial infarction (STEMI) ventricular storm. Methods Between January 2000 and December 2012, 119 patients with STEMI were enrolled in this study. According to the amount of smoking, no smoking (never smoking or occasional smoking ≤ 1 per day, or stopping smoking ≥ 3 (Group Ⅰ) 11 cases; small amount of smoking (regular smoking lasting 2 to 10 pieces / d, a small amount of smoking) (group Ⅱ) 39 cases; large number of smoking (≥ 11 pieces / d for smoking) (Group III) 69 cases. Analysis of its ECG and clinical high-risk prognosis. Results The negative value of electrocardiogram PTFv1 increased, ST elevation amplitude, QTc interval prolongation and other indicators were significantly abnormal, the incidence of group Ⅰ 9.2%, group Ⅱ 32.8%, group III the highest incidence of 58.0% The incidence of AMI, clinical concurrent hypotension and in-hospital mortality were higher in the composite anterior wall (P <0.01). Conclusions that smoking index and STEMI ventricular electrocardiogram abnormalities and clinical prognosis are closely related to the risk.