Objective To investigate the clinical value of electrocardiogram in the diagnosis of acute myocardial infarction (AMI),and to provide a more effective diagnostic method for the diagnosis of myocardial infarction.Methods Who were selected from April 2013 to April 2016 in our hospital treatment of 100 cases of acute myocardial infarction patients with super acute period,according to the time of onset were divided into A,B,C three groups,50 cases of A patients,30 cases of B patients,20 cases of C patients,A patients onset time shorter than 2H patients in the B group,the onset time of 2-6 h,C group of patients the onset of ＞6-8 h.3 groups of patients with 24 h ECG monitoring,recording ECG Q wave,ST segment and T wave changes,statistical analysis of experimental data to calculate the positive rate of change.Results The results of 24h ECG monitoring showed that the changes of ECG were mainly Q wave,ST segment and T wave.The sensitivity and specificity of ST segment changes in the diagnosis of acute myocardial infarction (AMI) in acute stage were higher than that of Q wave,and the difference was statistically significant (P＜0.05).The sensitivity and specificity of T wave in the diagnosis of acute myocardial infarction (AMI) in the acute stage and the positive predictive value and negative predictive value were higher than that of Q wave,and the difference was statistically significant (P＜0.05).The positive rates of A,B and C in three groups were 82％,33％ and 15％,respectively.The positive rate of A group was significantly higher than that of B group and C group,the difference was statistically significant (P＜0.05).In group ST patients with segment elevation myocardial infarction,the positive rate of ECG diagnosis was 40％,which was significantly higher than that of non ST segment elevation myocardial infarction (A),and the difference was statistically significant (P＜0.05).Conclusion The electrocardiogram in patients with acute myocardial infarction in super acute period especially provides great help for diagnosis and treatment time of onset in 2H patients,the characteristic ECG ST segment can be used as a super acute stage of acute myocardial infarction.%目的 探讨心电图在急性心肌梗死超急性期诊断中的临床价值,为心肌梗死的诊断提供更加有效的诊断方案.方法 随机选取2013年4月至2016年4月在我院住院治疗的急性心肌梗死超急性期患者100例,按照发病时间将患者分为A、B、C3组,A组患者50例,B组患者30例,C组患者20例,A组患者发病时间短于2h,B组患者发病时间为2～6 h,C组患者发病时间＞6～8 h.对3组患者进行24 h心电图监测,记录心电图Q波、ST段及T波的变化情况,统计实验数据后计算分析阳性改变率.结果 24 h心电监测结果显示患者的心电图阳性改变主要是Q波、ST段及T波的变化.ST段的改变诊断急性心肌梗死超急性期的敏感性和特异性及阳性预测值与阴性预测值均高于Q波,对比差异具有统计学意义(P＜0.05).T波的改变诊断急性心肌梗死超急性期的敏感性和特异性及阳性预测值与阴性预测值也均高于Q波,对比差异具有统计学意义(P＜0.05).A、B、C三组患者的阳性改变发生率分别为82％,33％和15％o,A组阳性改变发生率明显高于B组和C组,差异均具有统计学意义(P＜0.05).A组ST段抬高型心梗患者的心电图诊断阳性改变发生率为40％,明显高于非ST段抬高型心梗患者的20％,对比差异具有统计学意义(P＜0.05).结论 心电图为急性心肌梗死超急性期患者尤其是发病时间在2h内患者病情的诊断及治疗提供了巨大帮助,ST段抬高可以作为急性心肌梗死超急性期的特征性心电图表现.
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