作者：王艳琳，刘东升，刘娜，李国林，赵秀平，孙亚召

单位：

1.061001河北省沧州市人民医院心内科　2.061001河北省沧州市人民医院介入血管外科

Units：

1.Department of Cardiology, Cangzhou People's Hospital, Cangzhou 061001, China2.Department of Interventional Vascular Surgery, Cangzhou People's Hospital, Cangzhou 061001, China

关键词：

心肌梗死；De Winter综合征；临床特点；心电图；女性

Keywords：

Myocardial infarction; De Winter syndrome; Clinical characteristics; Electrocardiogram; Female

CLC：

R 542.22

DOI：

10.12114/j.issn.1008-5971.2023.00.261

Funds：

2022年度河北省医学科学研究课题计划（20220312）

摘要：

目的　分析女性De Winter综合征患者的临床特点和心电图特征。方法　选取2018-01-16至2022-01-29就诊于沧州市人民医院且符合De Winter综合征样心电图改变的患者73例，按照性别将其分为女性De Winter组（n=9）与男性De Winter组（n=64）。另选取同期沧州市人民医院收治的女性ST段抬高型心肌梗死（STEMI）患者231例作为女性STEMI组。比较女性De Winter组与男性De Winter组及女性De Winter组与女性STEMI组一般资料、实验室检查指标、左心室射血分数。观察女性De Winter综合征患者罪犯血管特征及心电图特征。结果　女性De Winter组中2例患者罪犯血管为左前降支（LAD）且完全闭塞，6例患者罪犯血管为LAD且次全闭塞，1例患者罪犯血管为第一对角支且次全闭塞。9例患者胸导联中ST段压低最深导联为V3导联者3例、V4导联者6例，其深度为1.0～5.0 mm；胸导联中T波振幅最高导联均为V3导联，振幅高度为6～15 mm；1例出现胸导R波移行区提前，6例出现aVR导联ST段抬高，6例出现Ⅲ导联ST段压低，7例出现aVF导联ST段压低。女性De Winter组胸导联中T波振幅最高导联的振幅高度低于男性DeWinter组（P＜0.05）。结论　女性De Winter综合征患者明显少于男性，但其临床特点与男性De Winter综合征患者及女性STEMI患者无明显差异。就心电图特征而言，女性De Winter综合征患者T波振幅高度低于男性，图形多不典型。

Abstract：

Objective To investigate the clinical and electrocardiogram characteristics of female patients withDe Winter syndrome. Methods A total of 73 patients with De Winter syndrome-like electrocardiogram changes admitted toCangzhou People's Hospital from January 16, 2018 to January 29, 2022 were selected and divided into female De Winter group(n=9) and male De Winter group (n=64) according to sex. Another 231 female patients with ST segment elevation myocardialinfarction (STEMI) admitted to Cangzhou People's Hospital during the same period were selected as female STEMI group. Thegeneral data, laboratory examination indexes and left ventricular ejection fraction were compared between female De Wintergroup and male De Winter group, and between female De Winter group and female STEMI group. The characteristics of culpritvessel and electrocardiogram in female De Winter syndrome patients were observed. Results In the female De Winter group, 2patients had left anterior descending (LAD) as the culprit vessel and were completely occluded, 6 patients had LAD as the culpritvessel and were subcompletely occluded, and 1 patient had the first diagonal branch as the culprit vessel and were subcompletelyoccluded. Among the 9 patients, V3 leads were in 3 cases and V4 leads were in 6 cases with the deepest chest lead ST segmentdepression and its depth was from 1.0 to 5.0 mm; the highest T-wave amplitude in the chest leads was V3 lead and the amplitudeheight was from 6 to 15 mm. Among the 9 patients, the R-wave migration zone was advanced in 1 case, ST segment elevationin aVR lead occurred in 6 cases, ST segment depression in Ⅲ lead occurred in 6 cases and ST segment depression in aVF leadoccurred in 7 cases. The amplitude height of the highest T-wave amplitude in the chest leads of the female De Winter group waslower than that of the male De Winter group (P < 0.05) . Conclusion The number of female De Winter syndrome patients issignificantly less than that of male De Winter syndrome patients, but there is no significant difference in clinical characteristicsbetween female De Winter syndrome patients and male De Winter syndrome patients or female STEMI patients. In terms of electrocardiogram characteristics, the T-wave amplitude height of female De Winter syndrome patients is lower than that of maleDe Winter syndrome patients, and the patterns are more atypical.

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