摘要
目的:观察不同心电图ST段偏移表现的非ST段抬高型心肌梗死(NSTEMI)患者临床特征,探讨依据心电图对其进行分类的临床意义。方法:早期行冠状动脉造影检查的NSTEMI患者203例,依据心电图ST段偏移方式的不同分为:ST段压低型心肌梗死组(压低组,121例)和ST段无偏移型心肌梗死组(无偏移组,82例)。分析患者的临床特征、冠状动脉病变特点、梗死相关动脉(IRA)及其介入治疗前后TIMI血流分级、患者病死率。结果:1无偏移组患者年轻、男性多见,心肌梗死及糖尿病病史较少见。2无偏移组中单支血管病变者明显多于压低组(χ2=14.868,P=0.002),且IRA以回旋支多见;IRA TIMI 0、1级的比率低于压低组(χ2=37.516,P<0.001)。无偏移组患者IRA侧支循环TIMI 2、3级的比率高于压低组患者(χ2=12.500,P<0.001)。3无偏移组中行急诊介入治疗的患者少于压低组(χ2=18.160,P<0.001)。2组患者病死率差异无统计学意义(χ2=1.810,P=0.178)。结论:NSTEMI患者临床表现较轻,但也要选择早期冠状动脉造影检查,并积极行介入治疗。
Aim:To explore the clinical features in patients with non-ST-elevation myocardial infarction ( NSTEMI) and different electrocardiographic manifestations .Methods:A total of 203 consecutive patients with NSTEMI undergone early coronary angiography .According to the difference of ST segment deviation pattern ,the patients were divided into two groups:ST-depression group(121 cases)and non-ST-deviation group(82 cases).The clinical characteristics,the lesion features of coronary artery,the mortality in hospital,infarction related artery(IRA)and its TIMI grades prior and after interventional therapy were analyzed.Results:(1)The young and male patients were less common for myocardial infarction and diabetes in non-ST-deviation group.(2)There were more single-vessel lesion in non-ST-deviation group(χ2 =14.868,P=0.002), and the IRA was often the circumflex artery .The rate of total occlusion of IRA in non-ST-deviation group was lower than that in ST-depression group(χ^2 =37.516,P〈0.001).Collateral circulation in non-ST-deviation group was better than that in ST-depression group(χ2 =12.500,P〈0.001).(3)It was more frequent in ST-depression group without primary percutane-ous coronary intervention than non-ST-deviation group(χ^2 =18.160,P〈0.001).The rates of death between the two groups had no significant differences (χ^2 =1.810,P=0.178).Conclusion:There are obvious differences between ST-depression and non-ST-deviation groups in clinical characteristics ,the lesion features of coronary artery ,therapy strategy and the mortal-ity in hospital .NSTEMI patients with different ECG manifestations should be treated with PCI in time .
出处
《郑州大学学报(医学版)》
CAS
北大核心
2014年第5期738-741,共4页
Journal of Zhengzhou University(Medical Sciences)
基金
国家级重点专科建设项目经费资助
河南省科技攻关计划项目资助122102310068
河南医学科技攻关计划项目课题资助201203104
关键词
非ST段抬高型心肌梗死
ST段无偏移
ST段压低
non-ST-elevation myocardial infarction
non-ST-segment deviation
ST segment depression