心电图检出心律失常与冠状动脉病变关系  

The relationship between arrhythmia and coronary artery disease

作　　者：杨进锋 陈艺钊[1] 

机构地区：[1]广西贵港市人民医院,537100

出　　处：《临床心电学杂志》2016年第3期201-203,207,共4页Journal of Clinical Electrocardiology

摘　　要：目的分析心电图检出心律失常与冠状动脉病变关系,为急性心肌梗死诊治、预后提供参考。方法选取我院120例急性心肌梗死患者为研究对象,所有患者均行动态心电图检测和冠状动脉造影,记录心律失常发生率,造影结果依照冠状动脉病变支数、病变血管、和狭窄程度进行分组,分析各种心律失常与冠状动脉病变情况的相关性。结果 120例中室性心律失常46例(39.0%),房性心律失常72例(61.0%)。ST段抬高79例(65.8%),ST段压低32例(26.7%),ST段无偏移9例(7.5%)。Lown3级及以上室性早搏发生率,冠状动脉多支病变(62.1%)显著高于单支病变(15.5%)(p<0.05);缓慢心率失常发生率,多支病变(55.6%)显著高于单支病变(22.2%)和双支病变(22.2%)(p<0.05);房性心律失常发生率,多支病变显著高于单支病变和双支病变(p<0.05)。频发室早发生率,左主干及前降支(71.4%)显著高于左回旋支(14.3%)和右冠状动脉(14.3%)(p<0.05);Lown3级及以上室性早搏发生率,左主干及前降支显著高于左回旋支和右冠状动脉(p<0.05)。而ST段抬高和ST段压低时,冠状动脉狭窄程度(大于90%)患者发生率最高。结论急性心肌梗死患者病程中多出现心律失常,且与冠状动脉病变情况密切相关,判断动态心电图检查下的心律失常有助于预判急性心肌梗死冠脉病变情况,为急性心肌梗死预后提供参考。Objective To analyze the relationship between arrhythmia and coronary artery disease, and to improve the diagnosis and treatment of acute myocardial infarction, and to improve the prognosis of patients with acute myocardial infarction. Methods 120 cases of acute myocardial infarction patients as the object of study. All patients underwent dynamic electrocardiogram and coronary angiography, and record the incidence of arrhythmia,angiographic findings according to the number of diseased coronary arteries, vascular lesions, and the degree of stenosis were grouped correlation analyze all kinds of arrhythmia and coronary artery lesions. Results in 120 cases, 72 cases（39%） and atrial arrhythmia in 46 cases（61%）. ST segment elevation in 79 cases（65.8%）, ST segment depression in 32 cases（26.7%）, ST segment without deviation in 9 cases（7.5%）. Lown3 level and above room VPC rate, coronary multivessel lesions（62.1%） was significantly higher than that of single vessel lesion（15.5%）（p〈0.05）;slow arrhythmia incidence, multivessel disease（55.6%） was significantly higher than that of single vessel lesion（22.2%）and double vessel lesion（22.2%）（p〈0.05）; The incidence of atrial arrhythmias, multivessel disease was significantly higher than that of single branch lesion, double vessel lesion（p〈0.05）. Frequent occurrence of ventricular premature rate, left main coronary artery and anterior descending branch（71.4%） was significantly higher than that of the left circumflex artery（14.3%） and the right coronary artery（14.3%）（p〈0.05）; The incidence of premature ventricular Lown3 level and above, the left main coronary artery and anterior descending branch was significantly higher than that of left circumflex branch and right coronary artery（p〈0.05）. And ST segment elevation and ST segment depression,the degree of coronary artery stenosis（greater than 90%） the highest incidence of patients. Conclusions Course of disease in patients with acute myocardial inf

关 键 词：急性心肌梗死 动态心电图 心律失常 冠状动脉病变 

分 类 号：R542.22[医药卫生—心血管疾病]