Abstract：Objective To investigate the clinical value of ECG in diagnosing acute myocardial infarction(AMI) in hyperacute phase. Methods Ninety patients diagnosed with AMI in hyperacute phase by our hospital from January 2013 to January 2015 were selected. They were randomly divided into three groups: A(55 cases), B(18 cases) and C(17 cases), with onset time of ≤2 h, 2-6 h and 6-8 h, respectively. Twenty-four hour ECG monitoring was carried out on the three groups. The changes of Q-wave, ST-segment and T-wave were carefully recorded, and the rates of positive changes were made statistic analysis. Results It was observed by 24hour ECG monitoring that positive ECG changes of all the enrolled cases were mainly Q-wave, ST-segment and T-wave changes. The sensitivity and specificity, and positive and negative predictive value of STsegment and T-wave changes were all higher than those of Qwave changes in diagnosing AMI in hyperacute phase. The incidence of positive ECG changes among the three groups was 81.82%, 38.89% and 17.65% in turn, with the rate of group A significantly higher than that of group B and C(P＜0.05). In the patients of group A, the diagnostic positive rate of ECG in the cases with STsegment elevation myocardial infarction was significantly higher than that in non-ST-segment elevation myocardial infarction patients(34.09% vs. 18.18%, P＜0.05). Conclusion It is critical to carry out 24-hour ECG monitoring on AMI patients in hyperacute phase, especially those within 2 hours of onset, in order to make accurate diagnosis and timely treatment. Wide and towering T-, and ST-segment elevation can be regarded as characteristic ECG manifestations of AMI in hyperacute phase, which provide references for clinical diagnosis and treatment.
2016, Vol. 25 
