摘要
目的 通过与冠状动脉造影对比,研究aVR导联ST段改变的特征对非ST段抬高型急性冠脉综合征病变血管的预测价值.方法 分析625例非ST段抬高型急性冠脉综合征患者一般资料、心电图、超声心动图及冠状动脉造影结果.结果 aVR导联无ST段抬高组(n=537)、ST段抬高0.05~0.1 mrn组(n=58)、ST段抬高>0.1 mm组(n=30)的左心室射血分数分别为53.6%±7.2%、50.2%±6.8%、48.2%±6.4%,3组比较差异有统计学意义(P=0.003);恶性心律失常(室性心动过速或心室颤动)发生率分别为3.4%、8.6%、13.3%,3组比较差异有统计学意义(P=0.008);病死率分别为2.2%、5.2%、10%,3组比较差异有统计学意义(P=0.026);左主干和(或)三支病变的发生率分别为24.8%、37.9%、56.7%,3组比较差异有统计学意义(P<0.0005).结论 非ST段抬高型急性冠脉综合征患者出现aVR导联ST段抬高对判断左主干或三支病变有预测价值,应引起高度重视.
Objectives To assess the value of lead aVR in diagnosing the severity of coronary artery disease in non-ST-elevation acute coronary syndrome (ACS) compared with coronary angiographic outcome.Methods General information,electrocardiogram,color doppler echocardiography and coronary angiographic outcomes of 625 cases with non-ST-elevation ACS were analyzed.Results Among 625 patients with non-ST-elevation ACS,537 had no ST-elevation in aVR,58 had minor (0.05-0.1 mm) ST-elevation in aVR and 30 had major (>0.1 mm) ST-elevation in aVR,their left ventricular ejection fraction (LVEF) were 53.6% ±7.2%,50.2%±6.8% and 48.2% ±6.4%,respectively (P=0.003) ;malignant arrhythmia (ventricular tachycardia or ventricular fibrillation) rates were 3.4%,8.6% and 13.3%,respectively (P=0.008) ; mortality rates were 2.2%,5.2% and 10%,respectively (P=0.026) ; incidences of left main and (or) three-vessel disease (LM/3-vd) were 24.8%,37.9% and 56.7%,respectively (P<0.0005).Conclusions ST-elevation in aVR can be useful in the early identification of LM/3-vd in patients with non-ST-elevation ACS,and it should be highly valued.
出处
《岭南心血管病杂志》
2014年第1期44-47,共4页
South China Journal of Cardiovascular Diseases
关键词
冠状动脉疾病
心电图
冠状动脉造影
coronary artery disease
electrocardiography
coronary angiography