老年非ST段抬高型急性冠脉综合征患者aVR导联ST段抬高与住院主要不良心脏事件的关系  

Relationship between aVR ST segment elevation and MACE in elderly patients with non ST segment elevation acute coronary syndrome

作　　者：刘湘华[1] 梁力晖[1] 唐铭翔[2] 

机构地区：[1]湖南省人民医院老年病科,湖南长沙410005 [2]湖南省人民医院心内科,湖南长沙410005

出　　处：《川北医学院学报》2016年第1期51-54,共4页Journal of North Sichuan Medical College

摘　　要：目的：探讨老年非ST段抬高型急性冠脉综合征患者a VR导联ST段抬高与住院主要不良心脏事件（major adverse cardiac events,MACE）的关系。方法：分析2012年1月至2015年1月医院就诊接受治疗的180例老年非ST段抬高型急性冠脉综合征患者（NSTE-ACS）的a VR导联心电图特征及急性冠脉综合征（acute coronary syndrome,ACS）患者MACE危险的因素。结果：a VR导联ST段抬高多发于年龄较大,既往有心绞痛、高脂血症病、高血压等病史者及左心室肥厚患者,经检验两组差异具有统计学意义（P〈0.05,P〈0.01）;a VR导联ST段抬高≥0.05 m V,年龄增加者,心功能Killip≥2级患者均显示院内死亡风险增加,院内死亡风险的OR值为4.32,95%可信区间为1.452~11.217,与非抬高组院内死亡人数相较差异有统计学意义（P=0.000）;心功能Killip≥2级在ACS患者院内死亡风险的OR值为6.128,95%可信区间为3.612~9.521,P=0.000;心力衰竭以及复发梗死发生率与a VR导联ST段抬高相关性较大（P〈0.05）。结论：a VR导联ST段抬高作为老年ACS独立预测因素提示患者可能有广泛的左主干和三支病变冠脉病变,且预后较差;a VR导联ST段抬高者院内心梗复发及心力衰竭高于非a VR导联ST段抬高者。Objective： To investigate the relationship between a VR ST segment elevation and MACE in elderly patients with non ST segment elevation acute coronary syndrome. Methods： To analyze the characteristics of a VR lead electrocardiogram and MACE risk factors of acute coronary syndrome patients with NSTE-ACS,180 cases from January 2012 to January 2015. Results： a VR ST segment elevation more often occurs in senior people with previous history of angina,hyperlipemia,hypertension and left ventricular hypertrophy,with statistical significance（ P 0. 05 by testing two groups,P 0. 01）. In a VR ST segment elevation group,patients with a VR ST segment elevation ≥ 0. 05 m V and cardiac function Killip≥2,as aging,their hospital mortality risk increased. The OR value of the hospital mortality risk was 4. 32 and 95% confidence interval was 1. 452 to 11. 217. Comparing with non-elevation group,the death toll has statistical difference（ P = 0. 000）. The OR value of the hospital mortality risk of ACE patients with cardiac function Killip≥ 2 was6. 128 and 95% confidence interval was 3. 612 to 9. 521,P = 0. 000. The incidence of heart failure and recurrent infarction was larger in the a VR lead ST segment elevation（ P 〈0. 05）. Conclusion： a VR lead ST segment elevation,as independent predictors of ACS in the senior people,suggests patients have a wide range of left main coronary artery lesions and three branch lesions,and poor prognosis. The recurrence of myocardial infarction and heart failure of a VR ST segment elevation patients in hospital were higher than that of non a VR lead ST segment elevation.

关 键 词：急性冠脉综合征 ST段抬高 预后 

分 类 号：R541.4[医药卫生—心血管疾病]