摘要
目的探讨非体外循环冠状动脉旁路移植术(OPCAB)后形成一过性J波伴T波高耸的相关因素及其意义。方法回顾性分析55例行OPCAB患者的临床资料,根据心电图是否出现J波伴T波高耸,分为有一过性J波伴T波高耸组(观察组18例)与无一过性J波伴T波高耸组(对照组37例),比较两组冠状动脉病变受累情况、冠状动脉狭窄的程度、手术持续时间、术后肌钙蛋白(cTnI)升高情况及年龄。结果观察组多支冠状动脉病变病例为94.4%(17/18),对照组则为32.4%(12/37),两者差异有统计学意义(P<0.005)。冠状动脉狭窄90%～100%者观察组占88.9%(16/18),而对照组则为35.1%(13/37)。手术持续时间均>3h观察组中18例,而对照组仅有15例(40.5)%,两组差异明显(P<0.005)。术后cTnI一过性升高(>0.1μg/L)、年龄>60岁的比率观察组分别为55.5%(10/18)和83.3%(15/18),而对照组分别为16.2%(6/37)和27.0%(10/37),差异均有统计学意义(P<0.005)。结论 OPCAB术后出现一过性J波伴T波高耸者提示冠状动脉病变程度重、范围广、年龄大、手术损伤大、心肌缺血、损伤程度严重,有潜在的发生恶性心律失常的危险,在临床上应引起足够的重视。
Objective To evaluate the factors associated with temporary J wave with T wave high-amplitude and its significations after off-pump coronary artery bypass（OPCAB） . Methods Data of 55 patients undergoing OPCAB surgery were retrospectively analyzed. According to the phenomenon whether the J wave with T wave high-amplitude were observed by ECG, the patients were divided into a J wave with T wave high-amplitude group （observation group, 18 patients） and non-J wave with T wave high-amplitude group （control group ,37 patients）. The culprit lesions, grades of coronary artery stenosis, duration of the operations, transient rise of cTnI after OPCAB and patients＇ ages of the two groups were compared. Results The rates of multi-vessel stenosis, coronary artery stenosis about 90% - 100%, the duration of the operations that lasted more than 3 hours, transient rise of cTnI （ 〉 0.1μg/L）after OPCAB and the ages above 60 of the observation group were higher than those of the control group[94.4% （17/ 18） to 32.4% （12/37）,88.9% （16/18） to 35. 1% （13/37）,100% （18/18） to 40.5% （15/37）, 55.5% （10/18） to 16.2% （6/37） ,83.3% （15/18） to 27.0% （10/37） ]. Differences were statistically significant （ P 〈 0. 005 ）. Conclusion The fact that the patients ECG showed J wave with T wave highamplitude after OPCAB suggested that the lesions of coronary artery diseases were severe, the ranges were wide, the ages were older, the surgery injury was serious, and the myocardial ischemia and injury were serious. There is a potential risk of malignant arrhythmia in the patients whose ECG showed J wave with T wave high-amplitude after OPCAB. Therefore we should pay sufficient attention to them in clinical.
出处
《实用心电学杂志》
2011年第2期96-99,共4页
Journal of Practical Electrocardiology
