摘要
目的探讨Aslanger征提示急性下壁心肌梗死合并其他冠状动脉(冠脉)严重病变的价值。方法 66例急性下壁心肌梗死患者,按照是否出现Aslanger征分为Ⅰ组(有Aslanger征, 26例)和Ⅱ组(无Aslanger征, 40例)。两组均进行心电图检测及冠脉造影,比较两组患者的心电图结果 ,冠脉造影结果 ,冠脉狭窄程度,冠脉病变支数。结果Ⅰ组患者的ST_(V3R~V5R)↑、ST_(V7~V9)↑、ST_(V4~V6)↓、ST_(V1)↑、ST_(avF)↓占比均高于Ⅱ组,差异具有统计学意义(P<0.05);两组患者的ST_(V1~V3)↓占比比较,差异无统计学意义(P>0.05)。Ⅰ组患者梗死部位在右冠状动脉(RCA)近端占比84.62%高于Ⅱ组的42.50%, RCA中远端占比11.54%、左冠状动脉回旋支(LCX)占比3.85%低于Ⅱ组的35.00%、22.50%,差异具有统计学意义(P<0.05)。Ⅰ组患者的冠脉狭窄程度重于Ⅱ组,差异具有统计学意义(Z=2.718, P=0.007<0.05)。Ⅰ组患者单支病变占比11.54%低于Ⅱ组的60.00%,双支病变占比42.31%、三支病变占比46.15%高于Ⅱ组的17.50%、22.50%,差异具有统计学意义(P<0.05)。结论 Aslanger征急性下壁心肌梗死患者梗死部位RCA近端及心电图相邻导联ST段抬高,存在Aslanger征急性下壁心肌梗死患者合并冠脉狭窄及病变的风险度更高。
Objective To discuss the value of Aslanger sign suggesting acute inferior myocardial infarction combined with other severe coronary artery disease.Methods A total of 66 patients with acute inferior myocardial infarction were divided into groupⅠ(with Aslanger signs,26 cases)and groupⅡ(without Aslanger signs,40 cases)according to whether there was Aslanger sign.Electrocardiogram and coronary angiography were performed in both groups.The results of electrocardiogram,coronary angiography,degree of coronary stenosis,and the number of coronary artery lesions were compared between the two groups.Results The proportions of STV3RV5R↑,STV7-V9↑,STV4-V6↓,STV1↑and STavF↓of groupⅠwere all higher than those of groupⅡ,and the difference was statistically significant(P<0.05).There was no statistically significant difference in proportion of STV1-V3↓between the two groups(P>0.05).The proportion of infarcts in the proximal right coronary artery(RCA)84.62%in groupⅠwas higher than 42.50%in groupⅡ,and the proportion of middle and distal RCA 11.54%and proportion of left coronary circumflex(LCX)3.85%were lower than 35.00%and 22.50%in groupⅡ.All the difference was statistically significant(P<0.05).The degree of coronary stenosis of groupⅠwas greater than that of groupⅡ,and the difference was statistically significant(Z=2.718,P=0.007<0.05).The proportion of singlevessel disease 11.54%of groupⅠwas lower than 60.00%of groupⅡ,and proportion of double-vessel disease 42.31%and proportion of three-vessel disease 46.51%were higher than 17.50%and 22.50%of groupⅡ.All the difference was statistically significant(P<0.05).Conclusion Aslanger sign refers to the elevation of the proximal RCA of the infarct site and the adjacent leads of the electrocardiogram in patients with acute inferior myocardial infarction.The presence of Aslanger sign indicates that patients with acute inferior myocardial infarction have a higher risk of coronary stenosis and disease.
作者
代少华
DAI Shao-hua(Gaoyao District People’s Hospital,Zhaoqing 526040,China)
出处
《中国实用医药》
2021年第13期10-13,共4页
China Practical Medicine
