| 双莲 陈凤英△ 崔晓迎 苏优勒 宁玉珍 杜辉.非ST 段抬高型急性冠脉综合征患者心电图aVR 导联ST段抬高与近期
预后的相关性分析[J].,2016,16(5):922-925 |
| 非ST 段抬高型急性冠脉综合征患者心电图aVR 导联ST段抬高与近期
预后的相关性分析 |
| Analysis on the Correlation between ecg aVR led ST Segment Elevation andRecent Prognosis of Non st-elevation Acute Coronary Syndrome Patients |
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| DOI： |
| 中文关键词: 急性冠脉综合征 心电图 aVR 导联 主要不良心脏事件 |
| 英文关键词: Acute coronary syndrome Electrocardiogram AVR lead Major adverse cardiac events |
| 基金项目:卫生部医药卫生科技发展研究中心基金项目（W2011GJ13） |
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| 中文摘要: |
| 目的：探讨非ST 段抬高型急性冠脉综合征(NSTE-ACS)患者心电图aVR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aVR 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-proBNP、
cTnI、CK-MB 高于对应组(P＜0.05)，LVEF 低于对应组；aVR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-proBNP、cTnI、冠脉左主干及三支病变与NSTE-ACS患者入院时aVR
导联ST段抬高呈正相关(P＜0.05)，而LVEF与其呈负相关(P＜0.05)；aVR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aVR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。 |
| 英文摘要: |
| 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
serumhs 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 patients with
NSTE-ACS. |
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