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目的 :探讨心电图对前壁AMI发生左心室附壁血栓的预测价值。方法 :全部病人均进行心电图检查 ,前 2d每 12h 1次 ,以后每日 1次 ,对第 2天和第 5天心电图ST段和T波方向进行仔细分析。第 5天心脏超声检查观察左心室有否附壁血栓。结果 :AMI后第 2天ST段抬高者 5 3例 (69% ) ,敏感性为 96% ,阳性预测值(PPV )为 3 9% ,阴性预测值(NPV )为 96%。第 2天至第 5天持续ST段抬高和T波直立者 ,特异性为 93 % ,PPV为 71% ;第 2天ST段位于基线 ,而T波倒置者无一例发生附壁血栓。结论 :心电图对前壁AMI发生左心室附壁血栓具有重要预测价值。
Objective: To investigate the predictive value of electrocardiogram for left ventricular wall thrombus in anterior myocardial infarction (AMI). Methods: All the patients underwent electrocardiogram examination, once every 12 hours in the first 2 days and once daily afterwards. The ST segment and T wave directions on the 2nd and 5th days were carefully analyzed. Day 5 Echocardiography The left ventricle was observed with or without thrombus. Results: 53 cases (69%) had ST-segment elevation on the second day after AMI, the sensitivity was 96%, the positive predictive value (PPV) was 39% and the negative predictive value (NPV) was 96%. ST-segment elevation and T-wave erection continued from day 2 to day 5 with a specificity of 93% and a PPV of 71%. On the second day, the ST segment was at baseline, and none of the T wave inversions occurred. Conclusion: ECG has important predictive value for the occurrence of left ventricular wall thrombus in anterior myocardial infarction.