稳定型心绞痛患者心电图avL导联的T波改变对冠状动脉狭窄预测的临床意义  

Clinical significance of T-wave changes in lead avL of the electrocardiogram for predicting coronary artery stenosis in patients with stable angina pectoris

作　　者：邹隽 张姝兰[1] 强佳琪 ZOU Jun;ZHANG Shu-lan;QIANG Jia-qi(Dalian Central Hospital,Dalian 116033,China)

机构地区：[1]大连市中心医院,116033

出　　处：《中国实用医药》2023年第2期72-75,共4页China Practical Medicine

摘　　要：目的探究稳定型心绞痛患者心电图avL导联的T波改变对冠状动脉狭窄预测的临床意义。方法90例稳定型心绞痛患者为研究对象,均使用心电图诊断及冠状动脉CT血管造影(CTA)诊断。并依据心电图avL导联T波形态分为三组:心电图正常患者30例,为正常组;avL导联T波改变患者30例,为T波改变组;多导联ST-T变化患者30例,为ST-T变化组。比较三组患者的临床资料,有无高血压史患者的冠状动脉评分,三组患者冠状动脉主要分支狭窄程度,分析冠状动脉评分与生化指标的相关性。结果三组患者的性别、年龄、高血压史比较,差异无统计学意义(P>0.05)。90例患者中,57例有高血压史,33例无高血压史。有高血压史患者的冠状动脉评分为(29.94±6.59)分,无高血压史患者的冠状动脉评分为(30.17±6.38)分。有无高血压史患者的冠状动脉评分比较,差异无统计学意义(P>0.05)。Pearson相关分析显示,冠状动脉评分与尿酸、同型半胱氨酸呈正相关(r=0.162、0.274,P<0.05);与低密度脂蛋白胆固醇、总胆固醇无相关性(r=0.043、0.029,P>0.05)。正常组、T波改变组、ST-T变化组患者左前降支(LAD)中段1.5的Gensini评分分别为(1.92±0.45)、(4.78±1.12)、(2.09±0.45)分,比较差异具有统计学意义(P<0.05)。三组患者小分支0.5、右冠状动脉(RCA)1.0、二对角0.5、LAD远段1.0、LAD/左回旋支(LCX)近段2.5、左主干5的Gensini评分比较,差异无统计学意义(P>0.05)。结论稳定型心绞痛患者心电图avL导联的T波改变与冠状动脉狭窄不具有相关性,但可作为冠状动脉狭窄的预测方法。Objective To investigate the clinical significance of T-wave changes in lead avL of the electrocardiogram for predicting coronary artery stenosis in patients with stable angina pectoris.Methods 90 patients with stable angina pectoris were studied.All patients were diagnosed by electrocardiogram and coronary artery CT angiography(CTA).The patients were also divided into three groups according to the T-wave morphology in the lead avL of electrocardiogram:30 patients with normal electrocardiogram,as the normal group;30 patients with T-wave changes in lead avL,as the T-wave change group;and 30 patients with ST-T changes in multiple leads,as the ST-T change group.The clinical data of the three groups,the coronary artery scores of patients with or without history of hypertension and the degree of stenosis of the main coronary artery branches in the three groups were compared,and the correlation between the coronary artery scores and biochemical indexes was analyzed.Results There was no statistically significant difference(P>0.05)in the comparison of gender,age,and history of hypertension among the three groups.Of the 90 patients,57 cases had a history of hypertension and 33 cases had no history of hypertension.The coronary artery score was(29.94±6.59)points in patients with a history of hypertension,and(30.17±6.38)points in patients without a history of hypertension.There was no statistically significant difference(P>0.05)in the comparison of coronary scores in patients with and without history of hypertension.Pearson correlation analysis showed that coronary artery score was positively correlated with uric acid and homocysteine(r=0.162,0.274;P<0.05);there was no correlation with low density lipoprotein cholesterol and total cholesterol(r=0.043,0.029;P>0.05).The Gensini scores of left anterior descending artery(LAD)middle 1.5 in patients in the normal group,T-wave change group,and ST-T change group were(1.92±0.45),(4.78±1.12),and(2.09±0.45)points,respectively,with statistically significant differences in compariso

关 键 词：冠状动脉狭窄 稳定型心绞痛 心电图 AVL导联 T波改变 生化指标 

分 类 号：R541.4[医药卫生—心血管疾病]