冠状动脉内心电图ST段改变对冠状动脉介入治疗相关心肌损伤的诊断价值  

Diagnostic value of electrocardiographic ST-segment changes for myocardial injury related to percutaneous coronary intervention

作　　者：周宇明 沈佳佳 Zhou Yuming;Shen Jiajia(Department of Cardiology,Haining People's Hospital,Haining 314400,Zhejiang Province,China)

机构地区：[1]海宁市人民医院心血管内科,海宁314400

出　　处：《中国基层医药》2022年第3期407-411,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省海宁市科技计划项目(2018062)。

摘　　要：目的探讨冠状动脉内心电图ST段改变对冠状动脉介入治疗(PCI)相关心肌损伤的诊断价值。方法选择2020年1月至2021年2月海宁市人民医院收治的择期行PCI患者60例为研究对象,对患者治疗前、后的血清肌钙蛋白I进行检测,并对患者冠状动脉内心电图ST段改变进行记录,以患者血清心肌钙蛋白I水平值为参照标准,分为心肌损伤组及无心肌损伤组,对心肌损伤影响因素进行分析。结果心肌损伤组球囊扩张时间为(85.6±56.2)min,支架长度为(25.2±15.2)mm,无心肌损伤组球囊扩张时间为(48.5±39.2)min,支架长度为(17.2±8.2)mm,两组差异均有统计学意义(t=-3.01、-2.42,均P<0.05);心肌损伤组患者的ST段变化[80.77%(21/26)]明显高于无心肌损伤组的5.88%(2/34)(χ^(2)=34.95,P<0.001);logistic多因素分析结果,冠状动脉内心电图ST段改变是患者发生心肌损伤的影响因素(r=69.25,P<0.05)。结论冠状动脉内心电图ST段改变是冠状动脉介入治疗相关心肌损伤的独立影响因素,可有效判断患者心肌损伤发生可能性,提高冠状动脉介入治疗的安全性。Objective To investigate the diagnostic value of electrocardiographic ST-segment changes for myocardial injury related to percutaneous coronary intervention.Methods We included 60 patients who received percutaneous coronary intervention in Haining People's Hospital from January 2020 to February 2021 in this study.We detected serum troponin I level before and after treatment and recorded electrocardiographic ST-segment changes.Taking serum troponin I level as a reference,we divided these patients into myocardial injury and non-myocardial injury groups and analyzed the influential factors of myocardial injury.Results Balloon inflation time and stent length were(85.6±56.2)minutes and(25.2±15.2)mm in the myocardial injury group,and they were(48.5±39.2)minutes and(17.2±8.2)mm in the non-myocardial injury group.There were no significant differences in balloon inflation time and stent length between the two groups(t=-3.01,-2.42,both P<0.05).The proportion of patients with electrocardiographic ST-segment changes was significantly higher in the myocardial injury group than in the non-myocardial injury group[(80.77%(21/26)vs.5.88%(2/34),χ^(2)=34.95,P<0.001)].Multivariable logistic regression analysis results showed that electrocardiographic ST-segment changes were an influential factor of myocardial injury(r=69.25,P<0.05).Conclusion Electrocardiographic ST-segment changes are an independent influential factor of myocardial injury related to percutaneous coronary intervention.It can effectively judge the possibility of developing a myocardial injury and increase the safety of percutaneous coronary intervention.

关 键 词：经皮冠状动脉介入疗法 心电描记术 心肌再灌注损伤 肌钙蛋白I ST段改变 

分 类 号：R541.4[医药卫生—心血管疾病]