目的通过对急性ST段抬高心肌梗死(STMI)患者心电图QRS波群形态进行缺血分级,探讨缺血分级对(STMI)患者发生严重心律失常的预测的临床意义。方法选择2008年1月至2012年3月在我科治疗的112例患者,标准:(1)缺血性胸痛≥30min。(2)心电图可见相邻两个或两个以上导联ST段抬高。(3)发病时间≤12h。结果入院时3级缺血组心律失常的发生率高于2级缺血组。结论入院时STMI3级缺血患者,溶栓后ST段回降不良,是发生严重心律失常的有效预测因素。 Objective To investigate the clinical significance of QRS complex morphology in patients with acute ST-segment elevation myocardial infarction (STMI) to predict the severity of arrhythmia in ischemic grading (STMI) patients. Methods One hundred and twelve patients were treated in our department from January 2008 to March 2012. The criteria were as follows: (1) ischemic chest pain ≥30min. (2) ECG showed two or more adjacent leads ST segment elevation. (3) onset time ≤ 12h. Results The incidence of arrhythmia in grade 3 ischemic group was higher than that in grade 2 ischemic group at admission. Conclusions STMI-3-deficient patients on admission have poor regression of ST-segment after thrombolysis and are effective predictors of severe arrhythmia.