不同类型急性冠脉综合征患者心电图改变及临床意义研究  

Study on the Change of ECG in Patients with Different Types of ACS and Its Clinical Significance

作　　者：艾清秀 杨兵 杨淑蓉 刘继东 胡剑 简雅婷 吕新科 

机构地区：[1]湖北省恩施州中心医院(西医部)超声诊断中心,湖北武汉445000 [2]武汉大学中南医院心内科,湖北武汉430071

出　　处：《现代生物医学进展》2015年第9期1685-1687,1694,共4页Progress in Modern Biomedicine

基　　金：湖北省自然科学基金项目(2010CDA038);国家自然科学基金面上项目(81070142)

摘　　要：目的:研究不同类型急性冠脉综合征(ACS)患者的心电图改变及其临床意义。方法:选取我院心血管科收治的ACS患者285例,分为非ST段抬高性心肌梗死组(NSTEMI,153例)和ST段抬高性心肌梗死组(STEMI,132例)。记录两组患者心电图发生ST段改变导联数,利用冠状动脉造影确定受累血管数及狭窄程度。结果:NSTEMI组患者单支血管受累比例低于STEMI组,多支血管受累比例高于STEMI组,差异具有统计学意义(P<0.05);两组患者血管狭窄程度无明显差异(P>0.05)。NSTEMI组发生ST段改变的导联数与冠脉血管受累数目存在正相关(r=0.355,P=0.000),与血管狭窄程度无明显相关性(r=0.576,P=0.176)。STEMI组发生ST段改变的导联数与冠脉血管受累数目及血管狭窄程度均无明显相关性(r=-0.005,0.153;P=0.927,0.221)。结论:非ST段抬高性心肌梗死患者以多支血管受累为主,且发生ST段改变的导联数越多,发生多支血管受累的几率越大,ST段抬高性心肌梗死患者以单支血管受累为主。Objective： To study the changes of electrocardiogram （ECG） of different types of acute coronary syndrome （ACS） patients and its clinical significance. Methods： 285 patients with ACS were selected and randomly divided into the NSTEMI group （non ST segment elevation myocardial infarction, 153 cases） and the STEMI group （ST segment elevation myocardial infarction, 132 cases）. Patients in two groups were recorded ECG ST segment changes the number of leads occurred, the use of coronary angiography to determine the involvement of vascular number and the degree of stenosis. Results： The ratio of single vessel involvement in the NSTEMI group was lower than that of the STEMI group, while the ratio of multiple vessel involvement was higher than that of the STEMI group with statistically significant differences （P〈0.05）; there was no significant difference in the vascular stenosis between the two groups （P〉0.05）. ST segment changes was positively correlated with the number of coronary vascular involvement in the NSTEMI group （r=0.355, P=0.000）, but it did not obviously correlate with the degree of stenosis （r=0.576, P=0.176）. There was no correlation of the ST segment changes with the number of coronary vascular involvement and the degree of stenosis in the STEMI group （r=-0.005, 0.153; P=0.927, 0.221）. Conelusions： The patients with non ST segment elevation myocardial infarction were mainly involved with multi vessels, and the number of leads of ST segment changes was more, then the probability of multiple branch of vascular involvement was greater; while the patients with ST segment elevation myocardial infarction was mainly in a single vessel involvement.

关 键 词：急性冠脉综合征 心电图 冠状动脉造影 临床意义 

分 类 号：R542.22[医药卫生—心血管疾病]