摘要
目的 探讨体表心电图aVR导联sT段抬高对急性心肌梗死患者梗死相关血管（IRA）诊断及临床预后的意义。方法收集2010年10月至2012年12月因急性心肌梗死入住我院的患者共240例，根据患者入院时心电图aVR导联sT段有无抬高，分为A组（AVrt导联sT段抬高）80例和B组（aVR导联sT段无抬高）160例，对两组患者临床资料、冠状动脉造影结果及主要不良心血管事件进行对比。结果①两组患者性别、糖尿病病史、PCI病史等一般临床资料对比差异无统计学意义（P〉0．05）。②两组冠状动脉造影结果比较：IRA为左主干（LM），A组9例，B组3例，两组比较差异有统计学意义（P〈0．01）；IRA左主干和（或）三支血管（LM／3VD），A组46例，B组15例，两组比较差异有统计学意义（P〈0．01）。3avR导联sT抬高对IRA为左主干的敏感性及特异性分别为75％和69％，对IRA为左主干和（或）三支病变的敏感度及特异度分别为73％和81％。④住院期间主要不良心血管事件（MAcE），A组36例，B组25例，两组比较差异有统计学意义（．P《O．01）。⑤在住院期间，aVR导联sT段抬高（OR=10．03，95％CI=5．36—18．77，P〈0．01）是急性心肌梗死患者发生不良心血管事件的独立危险因素。结论aVR导联sT段抬高提示急性心肌梗死患者梗死相关血管为左主干和（或）三支血管病变及住院期间不良心血管事件发生率增高。aVR导联ST段抬高对急性心肌梗死患者梗死相关血管判断及临床预后具有一定的临床指导意义。
Objective To investigate the value of ST segment elevation of aVR lead in identifying the in- farction -related artery （IRA） and prognosis in patients with acute myoeardiai infarction （AMI）. Methods 240 patients with acute myocardial infarction in our hospital were collected from October 2010 to December 2012 , according to the ST segment of aVR lead presenee of raise, was divided into group A （lead AVR ST segment elevation） of 80 eases and group B （lead AVR no raised ST segment） of 160 cases. Clinical data,coronary angiography results and clinical adverse cardiovascular events of two groups of patients were compared. Results （ 1 ）There was no significant difference in the patients whose the gender, diabetes history, PCI and general clinical data （P〉 0.05）. （2）There were significant difference in the patients whose infarct-related artery was left main stem（LM） between in the elevation group（9 cases）and no elevation group（3cases）（P〈0.01 ）.The patients whose infarct-relat- ed artery was left main stem and/or three vessels coronary disease （3VD） in elevation group （47 cases）were sig- nificantly higher than that of no elevation group（ 17 eases）（P〈0.01 ）. （3） The sensitivity and specificity of ST-seg- ment elevation in lead aVR for the LM as IRA was 75%, 69%, respectively, The sensitivity and specificity of ST- segment elevation in lead aVR for the LM and/or 3VD as IRA was 73% and 81%,respectively.（4）The eases with major adverse cardiac events （MACE） in elevation group （52 eases）were significantly higher than in no elevation group （25 cases）P〈0.01 ）. （5）During the period of hospitalization, lead aVR st-segment elevation （OR=10.03,95% CI=5.36-18.77, P〈0.01 ） was the only independent predictor of the for adverse cardiovascular events. Conclusion ST segment devation of aVR lead in acute myocardial infarcton patients had higher prevalence of left main stem and/or three vessels coronary disease, and higher adverse events rat
出处
《中国心血管病研究》
CAS
2013年第9期701-704,共4页
Chinese Journal of Cardiovascular Research
关键词
急性心肌梗死
AVR导联ST段抬高
梗死相关血管
主要不良心血管事件
Acute myocardial infarction
ST segment elevation of aVR lead
Infarction related artery
Major adverse cardiovascular events
