摘要
目的 探讨心电图aVR导联ST段变化对急性冠脉综合征(ACS)病变血管的预测价值。方法 回顾性分析2019年6月—2021年6月黄河中心医院治疗的425例ACS患者临床资料,依据aVR导联ST段变化情况将其分为三组,将aVR导联ST段无变化的319例患者纳入A组,将aVR导联ST段抬高0.05~0.10 mV的65例患者纳入B组,将aVR导联ST段抬高>0.10 mV的41例患者纳入C组。三组均进行标准的12导联或18导联心电图检查,计算aVR导联ST段抬高对病变血管的诊断敏感度及特异度。比较三组冠脉所累情况、恶性心律失常发生情况及住院病死率。结果 C组3支病变发生率>B组>A组,差异有统计学意义(P<0.05);C组左主干病变发生率高于A组,有统计学差异(P<0.05);A组与B组、B组与C组的左主干病变发生率比较,三组回旋支、右冠脉、前降支病变发生率比较,无统计学差异(P>0.05);aVR导联ST段抬高对左主干病变诊断敏感度为42.31%、特异度96.24%;aVR导联ST段抬高对3支病变诊断敏感度为50.65%、特异度89.08%;C组恶性心律失常发生率及住院病死率高于A组,有统计学差异(P<0.05);A组与B组、B组与C组的恶性心律失常发生率及住院病死率比较,无统计学差异(P>0.05)。结论 心电图aVR导联ST段变化对ACS患者病变血管具有预测价值,aVR导联ST段抬高的ACS患者3支病变或左主干病变发生率较高,恶性心律失常发生率及住院病死率增加,可通过观察心电图aVR导联ST段变化指导临床采取合理的治疗措施,以改善患者预后。
Objective To investigate the predictive value of ecg ST segment changes in aVR lead in patients with acute coronary syndrome(ACS).Methods The clinical data of 425 patients with ACS treated in Yellow River Central Hos-pital from June 2019 to June 2021 were retrospectively analyzed.According to the ST segment changes of aVR leads,they were divided into three groups,and 319 patients with no ST segment changes of aVR leads were included in Group A.65 patients with ST segment elevation of lead aVR of 0.05-0.10 mV were included in group B,and 41 patients with ST segment elevation of lead aVR of>0.10mV were included in group C.Standard 12-lead or 18-lead electrocardi-ogram was performed in all three groups to calculate the diagnostic sensitivity and specificity of ST segment elevation in aVR leads to diseased vessels.Coronary involvement,malignant arrhythmia occurrence and in-hospital mortality were compared among the three groups.Results The incidence of 3 branch lesions in group C was higher than that in group B and higher than that in group A(P<0.05).The incidence of left main disease in group C was higher than that in group A,with statistical difference(P<0.05).There was no statistical diference in the incidence of left main artery lesions between group A and group B,group B and group C,and the incidence of circumflex branch,right coronary ar-tery and anterior descending branch among the three groups(P>0.05).The sensitivity and specificity of ST segment elevation in aVR lead were 42.31%(11/26)and 96.24%(384/399),respectively.The sensitivity and specificity of ST segment elevation in aVR lead were 50.65%(39/77)and 89.08%.The incidence of malignant arrhythmia and inpatient mortality in group C were higher than those in group A,with statistical difference(P<0.05).There were no significant differences in the incidence of malignant arrhythmia and inpatient mortality between group A and group B,group B and group C(P>0.05).Conclusion aVR lead ecg ST segment changes in patients with ACS lesion vessels have predictive value,lead aVR of ST segment elevation ACS patients 3 lesions or left main disease incidence is higher,and hospital mortality increased incidence of malignant arrhythmia,but through the observation of avR lead ecg ST segment changes to guide clinical reasonable treatment measures,to improve patient outcomes.
作者
娄艳艳
褚莉莉
李佩哲
张晓晨
刘云霏
LOU Yan-yan;CHU Li-li;LI Pei-zhe;ZHANG Xiao-chen;LIU Yun-fei(Department of Intervention,Yellow River Central Hospital,Zhengzhou 450000 China;Cardiogram Room,the Seventh Peoples Hospital of Zhengzhou,Zhengzhou 450000,China)
出处
《医药论坛杂志》
2023年第18期102-105,共4页
Journal of Medical Forum
基金
河南省医学科技攻关计划联合共建项目(LHGJ20191120)。
关键词
急性冠脉综合征
病变血管
心电图
aVR导联ST段
恶性心律失常
病死率
Acute coronary syndrome
Diseased blood vessels
Electrocardiogram
aVR lead ST segment
Malignant ar-rhythmia
Case fatality rate
