急性非ST段抬高型心肌梗死患者aVR导联ST段抬高与SYNTAX评分的关系  

Relationship between aVR lead ST-segment elevation with SYNTAX score in patients with acute non-ST-segment elevation myocardial infarction

作　　者：王雅洁[1] 林文华[1] 敬锐[1] 刘菁晶[1] 卢宇杰[1] Wang Yajie;Lin Wenhua;Jing Rui;Liu Jingjing;Lu Yujie(First Department of Medicine, TEDA International Cardiovascular Hospital, Tianjin 300457, China)

机构地区：[1]泰达国际心血管病医院内一科,天津300457

出　　处：《临床荟萃》2021年第10期933-936,共4页Clinical Focus

摘　　要：目的探讨急性非ST段抬高型心肌梗死(NSTEMI)患者aVR导联ST段抬高(STEaVR)与STNTAX评分(SS)之间的关系。方法回顾性分析316例NSTEMI患者,对患者总体临床特征、入院时心电图ST段在不同导联的抬高及压低、在院期间超声左心室射血分数和峰值肌钙蛋白I水平等辅助检查以及冠状动脉造影术后所计算的SS进行统计及分析。以是否具有STEaVR对患者进行区组分析,探索STEaVR与SS之间的关系。结果316例NSTEMI患者中有STEaVR的207例(65.5%),无STEaVR的109例(34.5%)。有STEaVR患者的高SS评分(SS≥23)者比率更高(50.7%比21.1%,P<0.01),左主干和(或)三支病变的发生率更高(43.5%比22.9%,P<0.01)。多因素分析显示,STEaVR(OR=2.640,CI=1.404~4.963,P=0.003)以及前壁导联ST段压低(OR=1.817,CI=1.053~3.135,P=0.032)是高SS的独立预测因素。结论STEaVR是高SS的独立预测因素。Objective To explore the relationship between ST-segment elevation in lead aVR(STEaVR)and SYNTAX score(SS)in patients with acute non-ST-segment elevation myocardial infarction(NSTEMI).Methods Totally 316 patients with NSTEMI were retrospectively analyzed.Overall clinical features,electrocardiograms(ECGs)ST elevation and depression in different leads of patients unpon admission,scores and peak values of left ventricle ejection fraction(LVEF),peak troponinⅠlevel of the patients were counted and analyzed SS after coronary angiography.The patients with or without STEaVR were divied,the relationship between STEaVR and SS were explored.Results The number with STEaVR and without STEaVR in 316 patients was 207 cases(65.5%)and 109 cases(34.5%),respectively;the rate of patients with STEaVR gaining higher SS scores was higher when compared to those without STEaVR(50.7%vs 21.1%;P<0.01),and the incidence of left main coronary artery and/or three-vessel disease(LM/3VD)was higher(43.5%vs 22.9%;P<0.01).Multivariate analysis showed the independent predictors for higher SS were STEaVR(OR=2.640,CI=1.404-4.963,P=0.003)and precordial ST-segment depression(OR=1.817,CI=1.053-3.135,P=0.032).Conclusion The main independent predictor for higher SS is STEaVR.

关 键 词：ST段抬高型心肌梗死 心电描记术 冠状动脉造影术 

分 类 号：R541.4[医药卫生—心血管疾病]