摘要
【目的】探讨aVR导联T波方向与急性ST段抬高型心肌梗死患者冠脉病变程度的相关性。【方法】选择218例急性ST段抬高型心肌梗死患者临床资料,根据冠脉造影术前aVR导联T波方向,分为正向组（n=90）与非正向组（n=128）,比较两组患者间梗死相关血管、病变血管支数、Gensini积分等指标。再根据aVR导联T波正向组冠脉介入治疗术后的T波恢复情况,将其分为恢复组与未恢复组,观察冠脉介入治疗对aVR导联T波恢复情况的影响。【结果】T波正向组IRA前降支发生率高于T波非正向组,冠脉多支血管病变所占比例高于T波非正向组,侧支循环所占比例低于T波非正向组,组间比较差异均有统计学意义（均P〈0.05）。T波正向组Gensini积分轻度所占比例小于T波非正向组,重度所占比例高于T波非正向组,组间比较差异均有统计学意义（均P〈0.05）;aVR导联T波正向[OR=1.67,95%CI（1.029～3.077）,P=0.049〈0.05]、高龄[OR=1.023,95%CI（1.009～1.042）,P=0.045〈0.05]均是冠脉病变程度的危险因素;T波恢复组冠脉单支病变处理梗死相关血管（IRA）前降支所占比例显著高于T波未恢复组,PCI术前Gensini积分重度者所占比例显著低于T波未恢复组,差异均具有统计学意义（均P〈0.05）。【结论】aVR导联T波方向与急性ST段抬高型心肌梗死患者冠脉病变程度相关。
【Objective】To clarify the correlation between the T wave in lead aVR and the severity of coronary artery lesions in patient with ASTEMI. 【Methods】Clinical data of 218 patients with acute ST segment elevation myocardial infarction （ASTEMI）were divided into positive group （n=90） and non positive group （n=128） according to the aVR lead T wave direction before the coronary angiography.Comparison between two groups of infarction related artery vessel disease, Gensini score and other indicators were conducted. According to the recovery of T wave after percutaneous coronary intervention, the patients of aVR lead T wave positive group were divided into the recovery group and the non-recovery group.The effect of percutaneous coronary intervention on the recovery of T wave in aVR lead was observed.【Results】 The incident of IRA descending of the positive T wave group was higher than that of T non positive group, the proportion of multivessel lesions was higher than that of the non T positive group , the collateral circulation proportion was lower than that of the non T positive group,there was significant difference between the two groups （P〈0.05）; the Slight proportion of Gensini integral of the positive T wave group was less than that of non-positive T wave group,the Severe proportion was higher than that of non-positive T wave group, there was significant difference between the two groups （P〈0.05）; aVR lead T wave positive [OR=1.67,95% CI （1.029~3.077）,P=0.049〈0.05], aged [OR=1.023,95% CI （1.009~1.042）,P=0.045〈0.05] were all risk factors for coronary artery disease;The ratio of anterior descending branch of coronary artery （IRA） of single coronary artery lesion in the T wave recovery group was significantly higher than that of the T wave group; the proportion of patients with severe preoperative Gensini score of PCI was significantly lower than that of T wave group, the difference was statistically significant （P〈0.05）. 【Conclusion】The direction of T wave in aVR lead is correlated with the severity of coronary artery lesions in patients with acute ST segment elevation myocardial infarction.
出处
《医学临床研究》
CAS
2017年第2期303-306,共4页
Journal of Clinical Research
关键词
心肌梗死
急性病
心电描记术
冠状动脉疾病
Myocardial Infarction
Acute Disease
Electrocardiography
Coronary Artery Disease
