摘要
目的观察急性冠状动脉综合征(ACS)患者心电图(ECG)与冠状动脉造影(CAG)结果的关系。方法对107例由急诊科收入院的ACS患者的ECG及CAG结果进行分析。结果(1)不稳定型心绞痛及非ST段抬高的急性心肌梗死患者血管病变情况复杂,单支、2支、3支病变均占一定比例;急性前壁心肌梗死单支病变以左前降支病变为主,2支以上病变均包含左前降支病变;急性下壁心肌梗死单支病变以右冠状动脉病变为主,2支以上病变均包含右冠状动脉病变。(2)ST段抬高的急性心肌梗死与非ST段抬高的急性心肌梗死单支病变发病率差异无统计学意义(36%vs28%,P>0.05),2支以上病变发病率差异也无统计学意义(64%vs63%,P>0.05)。(3)<65岁组单支病变发病率明显高于≥65岁组(46%vs18%,P<0.01),<65岁组2支以上病变发病率明显低于≥65岁组(48%vs78%,P<0.01)。(4)ECG诊断ACS相关病变血管的特异度为100.0%,敏感度为33.3%。结论ST段抬高的急性心肌梗死患者ECG能基本确定相关病变血管,而非ST段抬高的急性心肌梗死及不稳定型心绞痛患者ECG不易确定相关病变血管,应尽早行CAG检查明确诊断;年龄越大,患者冠状动脉病变情况越复杂,亦应尽早行CAG检查。
Objective To observe relationship between electrocardiogram （ECG） and coronary arteriography（CAG） in patients with acute coronary syndrome （ACS）. Methods One hundred and seven patients with ACS were admitted into CCU ward by the green passageway of emergency room. Twelve - lead ECG was performed in above - mentioned patients in emergency room and CAG was also performed in those patients in CCU ward within 24 hours. The results of ECG and those of CAG were analysed. Results （ 1 ） The coronary vessel lesions in patients with unstable angina and non - ST segment elevation acute myocardial infarction （AMI） were complex. The vessel lesions includes single - branch and 2 - branch and 3 - branch lesions. The single - branch lesions in patients with acute anterior wall myocardial infarction were mainly left anterior descending branch（LAD） lesions, the 2 -branch and 3 - branch lesions both included LAD lesions. The single - branch lesions in patients with acute inferior wall myocardial infarction were mainly right coronary artery （RCA） lesions, the 2 - branch and 3 - branch lesions both included RCA lesions. （2）There was no significant difference in the incidence rate of the single - branch lesion and of the 2 - branch and 3 - branch lesions between ST segment elevation AMI and non - ST segment elevation AMI （36% vs 28%, P 〉 0.05 ; 64% vs 63 % ,P 〉 0.05 ）. （ 3 ） The incidence rate of the single -branch lesions in 〈65 years old group was much higher than that in 〉_-65 years old group （46% vs 18%, P 〈0.01 ）. The incidence rate of the 2 - branch and 3 - branch lesions in 〈 65 years old group was much lower than that in 〉_-65 years old group （48% vs 78% ,P 〈0.01 ）. （4）The specifici- ty and sensitivity of ECG used in diagnosing lesion - related vessels were 100.0% and 33.3% respectively.Conclusions Lesion- related vessels can be predicted roughly by ECG in ST segment elevation AMI, but lesion - related vessels are not easily predicted by ECG in non - ST segment elevation AMI and unstable angina pectoris group. The older the patients are, the more complicated the coronary artery lesions are. CAG should be performed on above -mentioned patients as early as possible.
出处
《中国医师进修杂志（内科版）》
2006年第10期36-38,共3页
Chinese Journal of Postgraduates of Medicine
