aVR导联ST段抬高结合肌钙蛋白I预测非ST段抬高型急性冠状动脉综合征患者预后  

a VR lead ST segment elevation combined with cardiac troponin I in prediction of prognosis of patients with Non-ST-segment elevation acute coronary syndrome

作　　者：张晓晖[1] 曾伟[1] 

机构地区：[1]泰山医学院附属医院心电图室,山东泰安271000

出　　处：《中国医药科学》2016年第18期11-14,24,共5页China Medicine And Pharmacy

摘　　要：目的探讨心电图a VR导联ST段抬高结合肌钙蛋白Ⅰ(c Tn I)在预测非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者预后中的价值。方法选择本院自2014年1月~2015年1月收集205例NSTEACS患者,对所有患者均测定c Tn I,测量心电图a VR导联ST段抬高程度并行冠脉造影,并根据结果分别行冠脉介入治疗或药物保守治疗,出院后随访6个月。205例患者分成四组:A组,c Tn I阴性结合a VR-ST不抬高组(100例);B组,c Tn I阴性结合a VR-ST抬高组(31例);C组,c Tn I阳性结合a VR-ST不抬高组(43例);D组,c Tn I阳性结合a VR-ST抬高组(31例)。观察分析四组间左主干病变或三支冠脉病变发生率及不良心血管事件(包括死亡、心肌梗死、再梗、血运重建)的发生率,P<0.05为差异有统计学意义。结果(1)左主干病变或三支冠脉病变发生率:D组显著高于A组(χ~2=78.9973,P=0.0000)、B组(χ~2=13.8091,P=0.0002)及C组(χ~2=44.7846,P=0.0000);B组显著高于A组(χ~2=19.7072,P=0.000)及C组(χ~2=10.8407,P=0.0009);A组与C组间无统计学差异(χ~2=0.0173,P=0.8952)。(2)不良心血管事件的发生率:D组显著高于A组(χ~2=89.4940,P=0.0003)、B组(χ~2=11.0878,P=0.0009)及C组(χ~2=38.5719,P=0.0005);B组显著高于A组(χ~2=29.8000,P=0.0005)及C组(χ~2=9.5431,P=0.0020);A组与C组间无统计学差异(χ~2=2.0582,P=0.1514)。结论联合心电图a VR导联ST段抬高和肌钙蛋白I阳性对预测NSTE-ACS患者的预后有重要的临床价值,值得心血管临床给予其更高程度的关注。Objective To investigate the value of electrocardiogram aVR lead ST segment elevation combined with cardiac troponin I in prediction of prognosis of patients with Non-ST--segment elevation acute coronary syndrome. Methods 205 cases of patients with Non-ST-segment elevation acute ~oronary syndrome from January 2014 to January 2015 in our hospital were included in our study.All patients were detected cTnI,detected ST segment elevation of aVR lead in electrocardiogram,and carried on coronary angiog^aphy.Aceording to the results,all of them Were followed up for 6 months after discharge.They were divided into 4group~：group A that was eTnI negative combined with AVR-ST non- elevation group （100 cases）,group B that was cTnI negative combined with AVR- ST elevation group（31 cases）,gr0up C that was cTnI positive combined with AVR-ST non- elevation group （43 cases）,group D that was cTnI positive＇ combined with AVR-ST elevation group （31 cases）.Incidence of left main lesion or three coronary artery disease and incidence of adverse cardiovascular events （including death, myocardial infarction,reinfarction,revascularization） of the four groups were observed.There were statistical significance （P 〈 0.05）. Results （1）Incidence of left main lesion or three coronary artery disease： group D was significantly higher than group A （X^2=78.9973,P=0.0000）,group B （X^2=13.8091.P=0.O002） and group：C （x^2=44.7846.P=0.0000）.Group B was significantly higher than group A （X2=19.7072,P=0.000） and goup C （x^2=lO.8407,P=0.0009）.There was no statistical significance between group A and group C （X^2=0.0173,P=0.8952）.（2）Incidence of adverse cardiovascular events：group D was significantly higher than group A （;（2=89.4940,P=0.0003）,group B （X^2=11.0878,P=0,0009） and group C（z2=38.5719,P=0.0005）.Group B was sinificantly higher than group A （X^2=29.8000,P=0.0005） and group C （X^2=9.5431,P=0.0020）.There was no statistical significance between group A and group C �

关 键 词：AVR导联ST段抬高 肌钙蛋白I 非ST段抬高型急性冠状动脉综合征 预后 

分 类 号：R541.4[医药卫生—心血管疾病]