作者：王艳琳，刘东升，刘娜，赵秀平，张天昊，李彬

单位：

河北省沧州市人民医院心内科

Units：

Department of Cardiology, Cangzhou People's Hospital, Cangzhou 061001, China

关键词：

心肌梗死; DeWinter综合征; 静止型DeWinter综合征; 动态演变型DeWinter综合征; 临床特点;

Keywords：

Myocardial infarction; De Winter syndrome; Static De Winter syndrome; Dynamic evolution De Winter syndrome; Clinical characteristics

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.112

Funds：

河北省医学科学研究课题计划项目（20220312）

摘要：

目的 对比分析静止型与动态演变型De Winter综合征患者的临床特点。方法 回顾性选取2018-01-16至2022-01-29就诊于沧州市人民医院的De Winter综合征患者73例为研究对象。根据心电图演变情况，将患者分为静止组（心电图维持不变或演变为正常心电图，n=24）和动态演变组[心电图演变为ST段抬高型心肌梗死（STEMI）图形，n=49]。收集所有患者一般资料、实验室检查指标、发病至出现De Winter图形时间及动态演变组患者出现De Winter图形至出现STEMI图形时间。结果 静止组罪犯血管TIMI血流分级0级者占比、空腹血糖低于动态演变组（P<0.05）。动态演变组出现De Winter图形至出现STEMI图形时间为586.0(1 526.5)min。以发病至出现De Winter图形时间的中位数为临界值，将动态演变组进一步分为A亚组（发病至出现De Winter图形时间≤96.0 min,n=25）和B亚组（发病至出现De Winter图形时间>96.0 min,n=24）。A亚组与B亚组一般资料、实验室检查指标、出现De Winter图形至出现STEMI图形时间比较，差异均无统计学意义（P>0.05）。结论 静止型De Winter综合征患者罪犯血管完全闭塞者占比及空腹血糖均低于动态演变型De Winter综合征患者。

Abstract：

Objective To compare and analyze the clinical characteristics of patients with static and dynamic evolution De Winter syndrome. Methods A total of 73 patients with De Winter syndrome admitted to Cangzhou People's Hospital from 2018-01-16 to 2022-01-29 were retrospectively selected as the research subjects. According to the evolution of the electrocardiogram, patients were divided into static group (electrocardiogram remained unchanged or evolved into a normal electrocardiogram, n=24) and dynamic evolution group [electrocardiogram evolved into a ST-segment elevation myocardial infarction (STEMI) pattern, n=49] . The general information, laboratory examination indexes, the time from onset to appearance of De Winter pattern of all patients and the time from appearance of De Winter pattern to appearance of STEMI pattern in the dynamic evolution group were collected. Results The proportion of culprit vessel with TIMI blood flow grade 0 and the fasting blood glucose in static group were lower than those in dynamic evolution group (P < 0.05) . The time from appearance of De Winter pattern to appearance of STEMI pattern in dynamic evolution group was 586.0 (1 526.5) min. Taking the median time from onset to appearance of De Winter pattern as the critical value, the dynamic evolution group was further divided into subgroup A (the time from onset to appearance of De Winter pattern was ≤ 96.0 min, n=25) and subgroup B (the time from onset to appearance of De Winter pattern > 96.0 min, n=24) . There were no statistically significant differences in the general information, laboratory examination indexes, and the time from appearance of De Winter pattern to appearance of STEMI pattern between subgroup A and subgroup B (P > 0.05) . Conclusion The proportion of culprit vessel with complete occlusion and fasting blood glucose in patients with static De Winter syndrome are lower than those in patients with dynamic evolution De Winter syndrome.

ReferenceList：