de Winter综合征的临床特征  

Clinical characteristics of patients with the de Winter electrocardiogram pattern

作　　者：刘李 田洁 王爱华[1] 杨爽[1] 徐晓丹 陈紫君[1] LIU Li;TIAN Jie;WANG Aihua;YANG Shuang;XU Xiaodan;CHEN Zijun(Department of Cardiology,Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院心血管内科,重庆402160

出　　处：《中南大学学报（医学版）》2020年第12期1431-1436,共6页Journal of Central South University ：Medical Science

基　　金：重庆医科大学附属永川医院资助(YJQN201418)。

摘　　要：目的:探讨deWinter综合征患者的心电图表现与临床特征。方法:回顾性分析2017年8月至2018年10月重庆医科大学附属永川医院收治犯罪血管为前降支病变的急性冠状动脉综合征(acute coronary syndrome,ACS)患者,分析其院前及院内心电图特征。根据是否出现de Winter综合征心电图特征分为de Winter组与对照组,通过查询纸质或电子病例收集入选患者的临床资料,进一步分析de Winter综合征心电图特征。结果:在230例犯罪血管为前降支的ACS患者中,14例(6.09%)患者出现de Winter综合征心电图表现。与对照组比较,de Winter组发病年龄更年轻[(53.86±10.26)岁vs(67.20±11.60)岁,P<0.01];LDL-C水平更高[3.54(2.88,4.20)mmol/L vs 2.61(2.48,2.73)mmol/L,P=0.01];心功能分级更低[Killip I级12例(85.71%)vs 95例(43.98%),P=0.04];发病至行首份心电图时间更短[171.77(47.56,295.97)min vs 501.92(405.12,598.72)min,P=0.01];冠状动脉造影结果提示前降支或对角支病变。结论:急性胸痛患者出现deWinter综合征心电图表现多数提示前降支或对角支次全或者完全闭塞,为ST段抬高型心肌梗死的等危症,应该引起临床医生的广泛关注。Objective:To explore the electrocardiogram manifestations and clinical characteristics of patients with the deWinter electrocardiogram pattern.Methods:This retrospective study was performed on acute coronary syndrome(ACS),patients with culprit lesion in left anterior descending branch(LAD),who admitted to Yongchuan Hospital of Chongqing Medical University from August 2017 to October 2018.Patients were categorized into those with or without the de Winter electrocardiogram pattern.The characteristics of de Winter electrocardiogram were analyzed by the clinical data of the patients.Results:Among 230 patients with left anterior descending branch lesion,14(6%)had the de Winter electrocardiogram pattern.Compared with the control group,patients with de Winter electrocardiogram pattern were younger[(53.86±10.26)years old vs(67.20±11.60)years old P<0.01],at higher LDL-C level[3.54(2.88,4.20)mmol/L vs 2.61(2.48,2.73)mmol/L,P=0.01],in lower classification degree of cardiac function[Killip I grade 12 cases(85.71%)vs 95 cases(43.98%),P=0.04],and in shorter time between onset and the first electrocardiogram[171.77(47.56,295.97)min vs 501.92(405.12,598.72)min,P=0.01].Coronary angiography results indicated anterior descending or diagonal branch lesions.Conclusion:The de Winter electrocardiogram pattern syndrome in patients with acute chest pain mostly indicates that the left anterior descending or the diagonal branch is subtotal or completely occluded,which is a special ST-segment elevation myocardial infarction equivalent and should attract the clinicians’extensive attention.

关 键 词：de Winter综合征 经皮冠状动脉介入治疗 溶栓治疗 

分 类 号：R541[医药卫生—心血管疾病]