摘要
目的研究急性冠状动脉综合征(ACS)患者体表心电图avL导联T波改变与其不良心血管终点事件的相关性。方法选取2015年3月—2018年3月湖南省郴州市第一人民医院就诊的ACS患者163例作为研究对象,依据其是否发生不良心血管终点事件分为预后良好组(101例)和预后不良组(62例),比较两组avL导联T波改变及其他相关指标与不良终点事件发生的关系。结果预后不良组avL导联T波改变、ST段抬高、ST段压低及病理性Q波发生率高于预后良好组(均P<0.05)。avL导联T波发生改变预测患者发生不良心血管终点事件与随访结果一致性较高(M=0.064,Kappa=0.759,P<0.05),灵敏度和特异性分别为91.93%、86.14%,阳性预测值和阴性预测值分别为80.28%、94.57%。logistic回归分析显示avL导联T波改变、病理性Q波、ST段抬高及急性心肌梗死(AMI)是发生不良心血管终点事件的独立危险预测因子。结论ACS患者体表心电图avL导联T波改变对不良心血管终点事件发生的预测价值较高,是不良心血管事件发生的独立危险预测因子。
Objective To study the correlation between T-wave changes of avL lead with the endpoints of major adverse cardiovascular events in patients with acute coronary syndrome(ACS).Methods A total of 163 cases with ACS patients who treated in Chenzhou No.1 People′s Hospital of Hu′nan Province from March 2015 to March 2018 were selected as the study objects.According to whether the endpoints of major adverse cardiovascular events occurred,they were divided into the good prognosis group(101 cases)and the poor prognosis group(62 cases).The relationship between the change of T-wave changes of avL lead and other related indexes was compared between the two groups.Results The incidence rate of T-wave changes of avL lead,ST segment elevation,ST segment depression and pathological Q wave in the poor prognosis group were higher than those in the good prognosis group(all P<0.05).The results of predicting the endpoints of major adverse cardiovascular events by T-wave changes of avL lead were highly consistent with the follow-up results(M=0.064,Kappa=0.759,P<0.05).The sensitivity and specificity were 91.93%and 86.14%,and the positive predictive value and negative predictive value were 80.28%and 94.57%,respectively.Logistic regression analysis showed that T-wave changes of avL lead,pathological Q,wave ST segment elevation and acute myocardial infarction(AMI)were independent risk predictors of the endpoints of major adverse cardiovascular events in patients.Conclusion The T-wave changes of avL lead in the body surface electrocardiogram of patients with ACS has a high predictive value for the end point of adverse cardiovascular events and is an independent risk predictor of major adverse cardiovascular events.
作者
涂丽君
张云强
董能斌
胡凯
TU Lijun;ZHANG Yunqiang;DONG Nengbin;HU Kai(Electrocardiogram Room,Chenzhou No.1 People′s Hospital,Hu′nan Province,Chenzhou423000,China;Department of Neurosurgery,Chenzhou No.1 People′s Hospital,Hu′nan Province,Chenzhou423000,China)
出处
《中国医药导报》
CAS
2020年第21期22-25,共4页
China Medical Herald
基金
湖南省卫生计生委科研计划课题项目(2015B215)。
