摘要
目的探讨体表心电图aVR导联ST段变化对急性冠状动脉综合征(ACS)患者罪犯血管定位和短期预后的预测价值。方法选取ACS患者共80例,根据心电图测量结果分为:aVR导联ST段抬高组(32例)、压低组(20例)和无偏移组(28例)。所有患者均行冠状动脉造影术及必要时PCI术,根据造影结果统计各组罪犯血管的分布,并比较各组间罪犯血管分布的差异。随访患者出院90 d内短期预后情况,比较各组间预后的差异。结果 aVR导联ST段抬高组左主干病变、前降支罪犯血管分布比例显著高于压低组和无偏移组;aVR导联ST段压低组回旋支、右冠状动脉罪犯血管分布比例显著高于抬高组和无偏移组;aVR导联ST段抬高组和压低组短期预后均明显差于无偏移组,差异均有统计学意义(P<0.05)。结论 aVR导联ST段抬高或压低对冠状动脉罪犯血管定位有一定的预测价值,并为后续的冠状动脉介入治疗和短期预后评估提供有价值的参考。
Objective To investigate the value of ST segment changes of the surface ECG lead aVR in predicting the distribution of culprit vessels and evaluating the short-term prognosis in patients with acute coronary syndrome( ACS). Methods A total of 80 patients with ACS were enrolled and divided into 3 groups according to the ST segment changes of lead aVR: the elevation group( 32 cases),the depression group( 20 cases) and the non-deviation group( 28 cases). All patients underwent the coronary angioplasty( CAG) and the percutaneous coronary intervention( PCI) if necessary. The distribution of coronary lesions in the three groups was counted based on the CAG records and the distribution differences among them were compared. The differences of short-term prognosis within 90 days after discharge among the three groups were also compared. Results The distribution ratio of culprit vessels of left main coronary and left anterior descending branch in the ST-segment elevation group was significantly higher than those in the depression group and non-deviation group( P < 0. 05). The distribution ratio of culprit vessels of left circumflex branch and right coronary in the ST-segment depression group was significantly higher than those in the elevation group and non-deviation group( P < 0. 05). The short-term prognosis in the patients with ST-segment elevation or depression of lead aVR was significantly poorer than that in the non-deviation group( P < 0. 05). Conclusion The ST-segment elevation or depression of lead aVR has some value in the prediction of distribution of coronary culprit vessels. Furthermore,it could provide valuable reference for the assessment of subsequent coronary intervention and short-term prognosis.
出处
《安徽医学》
2016年第5期536-539,共4页
Anhui Medical Journal
