心电图预判冠状动脉左回旋支急性闭塞严重程度及预后的临床价值  

Clinical Value of Electrocardiogram in Predicting Acute Occlusion of Left Circumflex Coronary Artery

作　　者：陈敏 CHEN Min(Cardiovascular Medicine Gutian County Hospital of Fujian Province,Gutian,352200,Fujian Province,China)

机构地区：[1]福建省古田县医院心血管内科,福建古田352200

出　　处：《中国实用乡村医生杂志》2023年第3期55-58,共4页Chinese Practical Journal of Rural Doctor

摘　　要：目的探讨心电图预判冠状动脉左回旋支急性闭塞患者的病变严重程度及预后临床价值。方法对2020年6月—2022年6月在古田县医院确诊的185例左回旋支急性闭塞导致急性心肌梗死患者的临床资料进行回顾性分析,根据心电图的不同变化模式分为ST-E组、ST-D组、N-ST组,比较三组患者间的临床资料、冠状动脉造影结果、心肌梗死面积以及30 d内不良心脏病事件发生情况。结果ST-E组、ST-D组、N-ST组患者肌钙蛋白I(troponin I,TnI)和肌酸激酶(creatine kinase,CK)水平差异均有统计学意义(均P<0.05);ST-E组、ST-D组、N-ST组左冠优势、三支病变和冠脉内血栓形成构成比差异无统计学意义(P>0.05);近端回旋支、远端回旋支、钝缘支、侧支循环构成比差异有统计学意义(P<0.05);ST-E组、ST-D组、N-ST组患者心肌梗死面积差异有统计学意义(P<0.05);ST-E组、ST-D组、N-ST组患者30 d内心律失常、心力衰竭和死亡发生率差异均无统计学意义(均P>0.05)。结论对冠状动脉左回旋支急性闭塞患者行心电图检查,可根据心电图的不同变化模式预判其心肌梗死严重程度及不良心血管事件发生风险,及时采取针对性治疗,改善患者预后。Objective To investigate the clinical value of electrocardiogram in predicting acute occlusion of left circumflex coronary artery.Methods A total of 185 patients with acute myocardial infarction due to acute occlusion of the left circumflex coronary artery were selected as the subjects of this retrospective analysis.The cases were collected from June 2020 to June 2022 in Gutian County Hospital of Fujian Province.All patients were divided into ST-E group,ST-D group,and N-ST group according to the different change patterns of electrocardiogram.The size of myocardial infarction and the incidence of adverse heart events within 30 days were compared among the three groups.Results The levels of troponin I(TnI)and creatine kinase(CK)in ST-E group,ST-D group and N-ST group were significantly different(all P<0.05).There were no significant differences in left coronary dominance,three-vessel lesions and intra-coronary thrombosis rate in ST-E group,ST-D group and N-ST group(P>0.05),while there were significant differences in circulation rates of proximal circumflex branch,distal circumflex branch,blunt margin branch and lateral branch in ST-E group,ST-D group and N-ST group(P<0.05).The myocardial infarction area of ST-E group,ST-D group and N-ST group was significantly different(P<0.05),and the myocardial infarction area of ST-E group was significantly higher than that of ST-D group and N-ST group.There were no significant differences in arrhythmia,heart failure and mortality within 30 days in ST-E,ST-D and N-ST groups(P>0.05).Conclusion The severity of myocardial infarction and the risk of adverse cardiovascular events can be predicted using electrocardiogram examination in patients with acute occlusion of left circumflex coronary artery according to the different changes of electrocardiogram,and timely reperfusion therapy can improve the prognosis of patients.

关 键 词：冠状动脉闭塞 心肌梗死 心电图 冠状血管造影术 

分 类 号：R542.22[医药卫生—心血管疾病]