摘要
目的:探讨非ST段抬高型急性冠脉综合征(NSTE-ACS)患者心电图a VR导联ST段抬高与近期预后的相关性。方法:将195例NSTE-ACS患者按照入院时a VR导联ST段是否抬高分为ST段抬高组和非ST段抬高组;记录两组患者的一般临床资料、实验室相关检查指标、冠脉病变情况以及住院期间是否发生主要不良心脏时间(MACE)等情况。结果:与非ST段抬高组比较,ST段抬高组患者心率较快、收缩压及舒张压较高,Killip分级≥2的比例亦较高(P<0.05);ST段抬高组患者血清hs-CRP、NT-pro BNP、c Tn I、CK-MB高于对应组(P<0.05),LVEF低于对应组;a VR导联以外ST段压低总例数及幅度亦高于非ST段抬高组(P<0.05);ST段抬高组患者中冠脉三支病变以及左主干的比例高于非ST段抬高组(P<0.05);与非MECE组比较,MECE组中入院AVR导联ST段抬高的比例及抬高的幅度较高(P<0.05);心率、NT-pro BNP、c Tn I、冠脉左主干及三支病变与NSTE-ACS患者入院时a VR导联ST段抬高呈正相关(P<0.05),而LVEF与其呈负相关(P<0.05);a VR导联ST段抬高是NSTE-ACS患者近期发生MACE的高危因素。结论:心电图a VR导联ST段抬高与严重广泛的冠脉病变及大面积心肌缺血有密切关系,可能是NSTE-ACS患者近期预后的独立危险因素。
Objective： To investigate the relevance of electrocardiogram aVR led st-elevation with the recent prognosis of patients with non st-elevation acute coronary syndromes（NSTE-ACS）. Methods： Divided the 195 patients with NSTE-ACS according to the aVR led ST segment raised or not on admission into aVR led st-elevation groups（n=54） and non aVR led st-elevation group（n=141）. Recorded the clinical data, laboratory tests, coronary artery lesions and major adverse cardiac（MACE） of patients in two groups. Results： Patients in aVR led st-elevation group had higher heart rate, higher systolic blood pressure and diastolic blood pressure, higher proportion of Killip classification ≥ 2 than those in non aVR led st-elevation group（P〈0.05）. The aVR led st-elevation group also had higher levels of serum hs CRP, NT-proBNP, cTnI, CK-MB than the corresponding group（P〈0.05）, but lower LVEF level than the corresponding group.The total cases and amplitude of aVR led outside ST segment were also higher than that of non aVR led st-elevation group（P〈0.05）. The proportion of patients with triple vessel disease and left main coronary lesions was higher in aVR led st-elevation group than in the non aVR led st-elevation group（P〈0.05）; Compared with, the proportion of aVR led st-elevation and amplitude in MECE group was higher than that in non MECE group（P〈0.05）. Logistic regression analysis showed that heart rate, NT-proBNP, cTnI, left main coronary artery and triple vessel disease were positively correlated with aVR led st-elevation of nste-acs patients on admission（P〈0.05）, but LVEF negatively correlated with it（P〈0.05）. Logistic regression analysis also showed that aVR led ST segment elevation was the high risk factor for NSTE-ACS patients with MACE. Conclusion： Ecg. aVR led st-elevation had a close relationship with the severe extensive coronary lesions and large area myocardial ischemia. It may be an independent risk factor for the development of recent outcomes for patien
出处
《现代生物医学进展》
CAS
2016年第5期922-925,906,共5页
Progress in Modern Biomedicine
基金
卫生部医药卫生科技发展研究中心基金项目(W2011GJ13)
