Hindman N, Grande P, Harrell F E, Anderson C, Harrison D, Ideker R E, Selvester R H, Wagner G S
Am J Cardiol. 1986 Jul 1;58(1):31-5. doi: 10.1016/0002-9149(86)90236-5.
The extent of initial acute myocardial infarction (AMI) and subsequent patient prognosis were studied using 2 independent indicators of AMI size. Two inexpensive, readily available techniques, the complete Selvester QRS score from the standard 12-lead electrocardiogram and the peak value of the isoenzyme MB of creatine kinase (CK-MB), were evaluated in 125 patients with initial AMI. The overall correlation between peak CK-MB and QRS score was fair (0.57), with marked difference according to anterior (0.72) or inferior (0.35) location. The prognostic capabilities of each measurement varied. Peak CK-MB provided significant information concerning hospital morbidity or early mortality (within 30 days) for both anterior (chi 2 = 9.83) and inferior (chi 2 = 7.68) AMI locations; however, the QRS score was significant only for anterior AMI (chi 2 = 9.50). For total 24-month mortality, the QRS score alone provided the most information (chi 2 = 10.0, p = 0.0016), which was not improved with the addition of CK-MB (chi 2 = 0.07, p = 0.79). This study shows a good relation between these 2 independent estimates of AMI size for patients with anterior AMI location. Both QRS and CK-MB results are significantly related to early morbidity and mortality; however, only the QRS score is related to total 24-month prognosis.
利用两个独立的急性心肌梗死（AMI）面积指标，对初始急性心肌梗死的范围及随后的患者预后进行了研究。在125例初始AMI患者中，对两种廉价且易于获得的技术进行了评估，即标准12导联心电图的完整塞尔维斯特QRS评分和肌酸激酶同工酶MB（CK-MB）的峰值。CK-MB峰值与QRS评分之间的总体相关性一般（0.57），根据梗死部位在前壁（0.72）或下壁（0.35）存在显著差异。每种测量方法的预后能力各不相同。CK-MB峰值为前壁（χ² = 9.83）和下壁（χ² = 7.68）AMI部位的医院发病率或早期死亡率（30天内）提供了重要信息；然而，QRS评分仅对前壁AMI有显著意义（χ² = 9.50）。对于总的24个月死亡率，仅QRS评分提供的信息最多（χ² = 10.0，p = 0.0016），加入CK-MB后并未改善（χ² = 0.07，p = 0.79）。本研究表明，对于前壁AMI患者，这两个独立的AMI面积评估指标之间存在良好的相关性。QRS评分和CK-MB结果均与早期发病率和死亡率显著相关；然而，只有QRS评分与总的24个月预后相关。
