急性ST段抬高型心肌梗死心电图Ⅲ级缺血与血清高敏肌钙蛋白Ⅰ关系的研究  

Relationship between grade Ⅲ ischemia of ECG and serum hs-cTnⅠ in patients with acute ST segment elevation myocardial infarction

作　　者：张琴[1] 杨苏萍[2] 秦国伟[1] 张雅莉[1] 陈晓婕[1] 卢志红[3] 杨霞芳[4] 洪基格 吴洁[1] 

机构地区：[1]广西壮族自治区人民医院心电诊断科,广西南宁530021 [2]广西壮族自治区人民医院科研部,广西南宁530021 [3]广西壮族自治区人民医院心血管内科,广西南宁530021 [4]广西壮族自治区人民医院检验科,广西南宁530021 [5]钦州市第一人民医院心血管内科,广西钦州535001

出　　处：《实用心电学杂志》2017年第3期179-182,共4页Journal of Practical Electrocardiology

基　　金：广西医疗卫生适宜技术研究与开发计划课题(桂卫S201314-02);广西科学研究与技术开发计划课题(桂科攻14279015);广西自然科学基金资助项目(2014GXNSFAA118274);广西卫计委计划课题(Z2015331)

摘　　要：目的通过急性ST段抬高型心肌梗死(STEMI)心电图QRS波群变化进行缺血分级,探讨心电图缺血与血清高敏肌钙蛋白Ⅰ(hs-cTnⅠ)的关系。方法根据入院心电图将120例STEMI患者分为Ⅲ级缺血组(QRS波终末变形)81例(67.5%)和Ⅱ级缺血组(QRS波终末不变形)39例(32.5%),两组均行冠脉造影及hs-cTnⅠ检测。比较两组冠脉血管病变发生情况与血清hs-cTnⅠ的关系。结果 (1)Ⅲ级缺血组中男68例(83.95%),女13例(16.05%);Ⅱ级缺血组中男27例(69.23%),女12例(30.77%),两组性别比较差异有统计学意义(P<0.05);(2)Ⅲ级缺血组患者左前降支病变发生率高于Ⅱ级缺血组(P<0.05),Ⅱ级缺血组患者左回旋支病变发生率高于Ⅲ级缺血组(P<0.001);(3)两组血清hs-cTnⅠ测定为偏态分布,差异有统计学意义(Z=-2.78,P<0.006);(4)Ⅱ级缺血组hs-cTnⅠ浓度低于Ⅲ级缺血组,差异有统计学意义(P<0.05)。结论 STEMI心电图Ⅲ级缺血与血清hs-cTnⅠ浓度有关。Objective Based on the ischemia classification according to the change of QRS com-plex in ECG of patients with acute ST segment elevation myocardial infarction （ STEMI） , to explore the relationship between electrocardiographic ischemia and serum hs-cTnl. Methods According to their ECGs on admission, 120 STEMI patients were divided into grade El ischemia group （with QRS terminal distortion; n = SI, accounting for 67. 5% ） and grade II is chemia group（without QRS ter-minal distortion ; n =39, accounting for 32.5%）. Coronary angiographic examination and hs-cTnl inspection were performed on both of the two groups. The relationship between the circumstances of coronary obstruction and serum hs-cTnl was compared between two groups. Results （i ） In grade IH ischemia group, there were 68 males（83. 95% ） and 13 females（ 16. 05 % ） ; in grade II ische-mia group, there were 27 males （ 69. 23 % ） and 12 females （30.11 %） . There was statistically sig-nificant difference in sex between the two groups （P 〈0. 05） . （ii） The incidence of lesion in left anterior descending artery among patients of grade IH ischemia group was higher than that in the oth-er group （ P 〈 0. 05 ） , however, the incidence of lesion in left circumflex artery was lower （P 〈 0.001）. （iii） The measured serum hs-cTnl was characterized by skew distribution with statistically significant difference（Z = - 2. 78 , P 〈 0 .006） . （ iv） Compared two groups of patients with hs-CT- nT level , grade Ⅱ ischemia is lower than the levels grade III ischemia, the difference was statisti-cally significant（P 〈 0. 05）. Conclusion Grade Ⅲ ischemia in ECG of STEMI patients is associat-ed with the concentration of serum hs-cTnl.[Key words] acute ST segment elevation myocardial infarction; myocardial ischemia; hs-cTnl

关 键 词：急性ST段抬高型心肌梗死 心肌缺血 高敏肌钙蛋白Ⅰ 

分 类 号：R542.2[医药卫生—心血管疾病]