[1]施晶晶,陶以嘉,徐大立.室性期前收缩形态诊断心肌梗死[J].心血管病学进展,2015,(5):655-658.[doi:10.3969/j.issn.1004-3934.2015.05.034]
　SHI Jingjing,TAO Yijia,XU Dali.Diagnosis of Myocardial Infarction by Ventricular Premature Beats[J].Advances in Cardiovascular Diseases,2015,(5):655-658.[doi:10.3969/j.issn.1004-3934.2015.05.034]
点击复制

室性期前收缩形态诊断心肌梗死()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2015年5期
页码:
655-658
栏目:
综述
出版日期:
2016-05-20

文章信息/Info

Title:
Diagnosis of Myocardial Infarction by Ventricular Premature Beats
作者:
施晶晶1; 陶以嘉1; 徐大立2
1.无锡市第三人民医院心内科,江苏 无锡 214041; 2.无锡天一医院心内科,江苏 无锡 214001
Author(s):
SHI Jingjing1; TAO Yijia1; XU Dali2
1.Cardiology Department, The Third People's Hospital of Wuxi, Wuxi 214041, Jiangsu, China; 2.Cardiology Department, The Tianyi Tospital of Wuxi, Wuxi 214001, Jiangsu, China
关键词:
病。室性期前收缩形态;  心肌梗死;  诊断标准;  诊断价值;  应用限制
Keywords:
ventricular premature beat;  myocardial infarction;  diagnostic criteria;  diagnostic value;  application restriction
分类号:
R542.2+2
DOI:
10.3969/j.issn.1004-3934.2015.05.034
文献标志码:
A
摘要:
急性心肌梗死心电图形态在窦性激动时未出现异常Q波而无法诊断时,可用室性期前收缩的Q波提前诊断心肌梗死,且能准确反映梗死的部位,具有显著的诊断急性心肌梗死的价值,特异性达97%。由于仅用单次描记心电图室性期前收缩出现概率自然会减少,敏感性约33%,若多次心电图描记和用Holter监测可提高其敏感性。并要结合病史,必要的检查,综合判断,不除外非梗死缺血性心脏病。
Abstract:
Acute myocardial infarction can not be diagnosed only based on electrocardiogram without abnormal Q wave in sinus rhythm. However, early diagnosis of myocardial infarction may still be possible if Q wave presented on ventricular premature beat. Q wave on ventricular premature beat can not only make an early diagnosis of myocardial infarction,but also predict the location of the infarction. Although the specificity may reach 97%, but the sensitivity showed only 33%, since the probability of register of a ventricular premature beat on single trace electrocardiogram is low. Repeating electrocardiogram recording or 24 hours Holter monitoring can improve the sensitivity significantly. The diagnosis, however, can not exclude the non-ischemic cardiomyopathy, therefore, the correct diagnosis should be established after carefully evaluated the clinic history, physical examinations and comprehensive judgement.

参考文献/References:

[1] 上海医科大学.实用内科学[M].第九版.人民卫生出版社,1993:1117.
[2] Saint & Frances C.Saint Frances Guide to Inpatiens Medcine[M].Lippincott Williams & Wilkins Asia Ltd,1999:73-74.
[3] 王吉耀.普通高等教育“十五”国家级规划内科学[M]. 人民卫生出版社,2006:283-289.
[4] 徐大立,陶以嘉,刘颖.急性冠脉综合征研究进展[J].中华医学研究杂志,2006,6:152-153.
[5] 陶以嘉,钱中良,徐大立.急性冠状动脉综合征与阿托伐他汀[J].心血管病学进展,2013,24(1):154-155.
[6] 钱中良,陶以嘉,徐大立.急性冠脉综合征的最佳治疗[J].心血管病学进展,2013,34(2):229-230.
[7] Braumald E,Antmen EM,Beaslcy JW,et al. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines(committee of the management of patients with unstable angina)[J].J Am Coll Cardiol,2000,36:970-1062.
[8] 徐大立,陶以嘉.急性心肌梗塞研究进展[J]. 心血管病学进展,2005,26:86-87.
[9] 黄峻.现代循证心脏病学[M]. 江苏科技出版社,2003:154-156.
[10] Cohen J.Acute myocardial infarction early and objective diagnosed through ventricular extresystoles[J]. Am J Cardiol,1961,7(6):882.
[11] Wahl JM.Limitations of premature ventricular complex morphology in the diagnosis of myocardial infarction[J].J Electrocardiol,1986,19(2):131.
[12] Soloff IA.Ventricular premature beats diagnostic of myocardial disease[J].Am J Med Sci,1961,242(3):315-316.
[13] 包玉清. 心电学[M].上海市六院,1989:3.
[14] Schamroth L.Ventricular extrasystoles,ventricular tachycardia and ventricular fibrillation,clinical-electrocardiographic considerations[J].Prog Cardiovasc Dis,1980,23(1):13.
[15] Dach H.Morphology of ventricular premature beats as an aid in the electrocardiographic diagnosis of myocardial infarction[J].Am J Cardiol,1983,52(5),458.
[16] Bisteni A.Ventricular premeture beat in the diagnosis of myocardial infarction[J].Br Heart J,1961,23(5):521.
[17] Frenudlich J.The significance of ventricular premature beats in the diagnosis of septal infarction[J].Can Med A Soc J,1964,91(22):145.
[18] Anttonen VM. The diagnostic value of unipolar precardial patterns of ventricular premature beats in myocardial infarction[J].Acta Med Scand Suppl,1962,387:1-65.
[19] Goldoerger AL.Recognition of ECG pseudo-infarct patterns[J].Mod Concepts Cardiovasc Dis,1980,49(3):13-15.
[20] Zhong Y,Cao P,Tong CF,et al.Effects of ramipril on ventricular arrhythmia after myocardial infarction in rabbits[J]. World J Emerg Med,2014,8:135.
[21] Robbers LF,Delewi R,Nijreldt R,et al.Myocardial infarct heterogeneity assessment by late gadolinium enhancement cardiovascular magnetic resonance imaging shows predictive value for ventricular arrhythmia development after acute myocardial infarction[J].Eur Heart J Cardiovasc Imaging,2013,14(12):1150-1158.
[22] 阮虹.由室早形态诊断心肌梗死[J].心电学,1988,63(7):11-12.
[23] 陶长生.临床心电图进展[M]. 东南大学出版社,1991:75-76.

相似文献/References:

[1]宋菲,综述,俞梦越,等.干细胞来源的外泌体:心肌梗死治疗新启示[J].心血管病学进展,2016,(2):125.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.007]
　SONG Fei,YU Mengyue.Exosomes Derived from Stem Cells: Novel Approach in Treatment of Myocardial Infarction[J].Advances in Cardiovascular Diseases,2016,(5):125.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.007]
[2]颜晶,综述,常静,等.半乳糖凝集素3在心肌梗死中的研究进展[J].心血管病学进展,2016,(2):129.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.008]
　YAN Jing,CHANG Jing.Research Advances in the Role of Galectin-3 in Myocardial Infarction[J].Advances in Cardiovascular Diseases,2016,(5):129.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.008]
[3]许利冬,综述,李为民,等.左主干解剖形态与左冠状动脉粥样硬化研究新进展[J].心血管病学进展,2016,(2):173.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.020]
　XU Lidong,LI Weimin.New Progress Between Left Main Coronary Anatomy and Left Coronary Atherosclerosis[J].Advances in Cardiovascular Diseases,2016,(5):173.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.020]
[4]刘如晨,综述,徐争鸣,等.血栓抽吸在急性ST段抬高型心肌梗死中的研究进展[J].心血管病学进展,2016,(3):240.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.006]
　LIU Ruchen,XU Zhengming,LI Tianchang.Thrombus Aspiration in the Treatment of Acute ST-segment Elevation Myocardial Infarction[J].Advances in Cardiovascular Diseases,2016,(5):240.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.006]
[5]王艳,综述,石蓓,等.心脏干细胞修复梗死心肌作用机制的研究进展[J].心血管病学进展,2016,(3):315.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.027]
　WANG Yan,SHI Bei.Research Progress of Cardiac Stem Cells Repairing Infarction Myocardial Function Mechanism[J].Advances in Cardiovascular Diseases,2016,(5):315.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.027]

备注/Memo

备注/Memo:
作者简介:施晶晶(1973—),副主任医师,主要从事心血管病及冠状动脉介入治疗研究。Email:mao970202@163.com 徐大立(1936—),特聘主任医师,教授,博士生导师,主要从事心血管病前沿研究。Email:lydia@gmbsino.com 通信作者:陶以嘉(1957—),主任医师,教授,主要从事心内科与介入治疗研究。Email:yijiatao@163.com
更新日期/Last Update: 2016-05-20