急性心肌梗死心电图aVR导联ST段改变与梗死冠脉数量及预后的相关性  

The correlation between ST segment changes of aVR lead and the number and prognosis of infarcted coronary artery in acute myocardial infarction

作　　者：俞晋虹 江小娟 Yu Jinhong;Jiang Xiaojuan(Functional department of jiading traditional Chinese medicine hospital,Shanghai,201899,China)

机构地区：[1]上海市嘉定区中医医院功能科

出　　处：《现代仪器与医疗》2019年第6期57-60,共4页Modern Instruments & Medical Treatment

摘　　要：目的:分析急性心肌梗死心电图aVR导联ST段改变与梗死冠脉数量及预后的相关性。方法:选取医院2016年8月至2019年2月收治的464例急性心肌梗死患者进行研究,根据心电图aVR导联ST段改变情况进行分组,比较抬高组、无偏移组和下移组冠脉病变数量、梗死相关血管和不良心血管事件发生情况。结果:抬高组与下移组冠脉病变数量以三支病变为主,发生率高于无偏移组,而无偏移组以单支病变为主,发生率高于抬高组与下移组,差异有统计学意义(P<0.05)。抬高组梗死相关血管以左主干和左前降支近端为主,占比明显高于无偏移组与下移组,下移组以左回旋支为主,占比明显高于抬高组与无偏移组,差异均有统计学意义(P<0.05)。抬高组与下移组心力衰竭、心因性死亡、恶性心律失常和非致病性心肌再梗发生率均高于无偏移组,差异有统计学意义(P<0.05)。结论:aVR导联ST段改变可能提示三支病变和不良预后,其中抬高可能提示左主干和左前降支近端病变,下移可能提示左回旋支病变。Objective:To analyze the correlation between ST segment changes of aVR lead and the number and prognosis of infarcted coronary artery in acute myocardial infarction.Methods:464 patients with acute myocardial infarction admitted to our hospital from August 2016 to February 2019 were selected for the study.According to the changes of ST segment in aVR lead of electrocardiogram,they were divided into three groups.The number of coronary artery lesions,infarction-related vessels and adverse cardiovascular events in elevation group,non-deviation group and descending group were compared.Results:The number of coronary artery lesions in the elevation group and the descending group was mainly three-vessel lesions,the incidence was higher than that in the non-migration group,and the incidence of single-vessel lesions in the non-migration group was higher than that in the elevation group and the descending group,the difference was statistically significant(P<0.05).The proportion of infarction-related vessels in the elevation group was higher than that in the non-migration group and the down-migration group,and the left circumflex branch was the main one in the down-migration group,which was significantly higher than that in the elevation group and the non-migration group(P<0.05).The incidence of heart failure,psychogenic death,malignant arrhythmia and non pathogenic myocardial infarction were higher in the elevation group and the lower group than in the non offending group,the difference was statistically significant(P<0.05).Conclusion:ST segment changes in lead aVR may indicate three vessel lesions and adverse prognosis.Elevation may indicate lesions of left main and proximal left anterior descending branch,and downward movement may indicate lesions of left circumflex branch.

关 键 词：心电图 急性心肌梗死 预后 冠状动脉造影 

分 类 号：R542.2[医药卫生—心血管疾病]