非Q波与Q波心肌梗死的临床分析

本组急性心肌梗死１１２１例中，非Ｑ波心肌梗死３９２例（３５％），Ｑ波心肌梗死７２９例（６５％）。既往有心绞痛及心肌梗死者，在非Ｑ波心肌梗死组分别有７６．８％及３８．８％，显著地多于Ｑ波心肌梗死组的６１．２％及３０．６％。有高血压、糖尿病史及吸烟者，两组间比较无差别。并发泵衰竭、室性心动过速和（或）心室颤动及Ⅱ～Ⅲ度房室传导阻滞者，在非Ｑ波心肌梗死组分别有１０．２％、１０％及１．５％，显著地少于Ｑ波心肌梗死组的１９．３％、２０．６％及１３．６％。梗死后心绞痛者，在非Ｑ波心肌梗死组有４５．２％，显著地多于Ｑ波心肌梗死组的２８．９％。４周病死率，在非Ｑ波心肌梗死组为２．８％，显著地低于Ｑ波心肌梗死组的８．２％。非Ｑ波与Ｑ波心肌梗死比较，患者在急性期并发症较少，病死率较低；而梗死后早期心绞痛较多。

CLINICAL ANALYSIS OF NON-Q WAVE AND Q WAVE MYOCARDIAL INFARCTION

The clinical records of 1121 patients with acute myocardial infarction admitted from 1987 to 1993 were reviewed. Among them, non-Q wave (NQWMI) and Q wave myocardial infarction (QWMI) were detected in 392 (35%) and 792 (65%) cases, respectively. Significantly more cases with past history of angina pectoris and myocardial infarction were found in the NQWMI than in the QWMI (76. 8% and 38. 8% vs. 61. 2% and 30. 6%, respectively), but with no marked difference of hypertension, diabetes mellitus, and smoking between the two groups. Severe pump failure, paroxysmal ventricular tachycardia and/or ventricular fibrillation, and second and/or third degree atrioventricular block were significantly less in the NQWMI group (10. 2% , 10% and 1. 5%, respectively) than in the NQMI group ( 19. 3%,20. 6% and 13. 6%, respectively). The incidence of early postinfarction angina in the NQWMI group was markedly higher than in the QWMI group (45. 2% vs. 28. 9%, P<0.01). The total 28-day mortality in patients with NQWMI was 2. 8 percent, which was significantly less than 8. 2 percent in those with QWMI.The results showed that complications were significantly less and total 28-day mortalty was remarkably lower in patients with NQWMI than in those with QWMI. However, early postinfarction angina was remarkably more in patients with NQWMI than in those with QWMI.