急性冠状动脉综合征患者aVL导联T波倒置对左前降支中段狭窄的预测价值  

Value of T wave inversion of lead aVL for predicting middle left anterior descending branch stenosis in ACS patients

作　　者：吕常智 杨闯[2] 徐万林 LüChangzhi;Yang Chuang;Xu Wanlin(Second Department of Cardiology,Dandong No.1 Hospital,Dandong 118000,Liaoning Province,China)

机构地区：[1]丹东市第一医院心内二科,118000 [2]吉林大学第二医院心血管内科 [3]吉林大学第一医院心血管疾病诊治中心

出　　处：《中华老年心脑血管病杂志》2022年第1期43-46,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨急性冠状动脉综合征(ACS)患者心电图aVL导联T波倒置与左前降支中段病变的关系。方法选择2019年1月~2020年12月丹东市第一医院心内二科就诊的ACS患者265例,根据T波情况分为T波倒置组102例,非T波倒置组163例。入院后,对患者予以常规冠状动脉造影、心电图等相关检查。分析aVL导联T波倒置与左前降支中段狭窄的关系。结果2组病变类型、校正QT间期、LVEF比较,有统计学差异(P<0.05,P<0.01)。T波倒置组左前降支中段狭窄程度明显高于非T波倒置组[(58.36±27.40)%vs(31.63±28.54)%,P=0.001]。一致性检验显示,aVL导联T波倒置预测急性心肌梗死患者左前降支中段堵塞≥50%中等程度一致(Kappa=0.499,P<0.01),预测不稳定性心绞痛≥50%中等程度一致(Kappa=0.465,P<0.01)。多因素logistic回归分析显示,aVL导联T波倒置与左前降支中段狭窄程度相关(OR=4.671,95%CI:1.424~13.244,P=0.012)。结论ACS患者心电图检查中,aVL导联T波倒置是预测左前降支中段狭窄程度的有力指标之一。Objective To analyze the relationship between T wave inversion of lead aVL on ECG and middle left anterior descending branch stenosis in acute coronary syndrome(ACS)patients.Methods Two hundred and sixty-five ACS patients admitted to our hospital from January 2019 to December 2020 were divided into T wave inversion group(n=102)and T wave inversion-free group(n=163).The patients underwent conventional coronary angiography and ECG after ad-mission.The relationship between T wave inversion of lead aVL on ECG and middle left anterior descending branch stenosis in ACS patients was analyzed.Results Significant difference was de-tected in different types of stenosis,adjusted QTC,and LVEF between the two groups(P<0.05,P<0.01).The middle left anterior descending branch stenosis was significantly severer in T wave inversion group than in T wave inversion-free group(58.36%±27.40%vs 31.63%±28.54%,P=0.001).Consistency test showed that T wave inversion of lead aVL on ECG could predict≥50%middle left anterior descending branch obstruction and≥50%unstable angina pectoris in acute myocardial infarction(AMI)patients(Kappa=0.499,P<0.01;Kappa=0.465,P<0.01).Multivariate logistic regression analysis displayed that T wave inversion of lead aVL on ECG was related with middle left anterior descending branch stenosis in AMI patients(OR=4.671,95%CI:1.424-13.244,P=0.012).Conclusion T wave inversion of lead aVL on ECG is one of the predictors for middle left anterior descending branch stenosis in ACS patients.

关 键 词：急性冠状动脉综合征 冠状血管造影术 ST段抬高型心肌梗死 心电描记术 

分 类 号：R541.4[医药卫生—心血管疾病]