冠脉搭桥术后心电图T波改变与心室晚电位的检测分析  

Correlation Analysis of Electrocardiographic T-wave Changes and Late Ventricular Potentials After Coronary Artery Bypass Grafting

作　　者：牧丹 王瑞 MU Dan;WANG Rui(Baotou Medical College of Inner Mongolia University of Science and Technology,Baotou 014040 China;Department of Cardiac Function,People's Hospital of Inner Mongolia Autonomous Region,Hohhot 010017 China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014040 [2]内蒙古自治区人民医院心功能科,呼和浩特010017

出　　处：《内蒙古医学杂志》2023年第5期566-569,共4页Inner Mongolia Medical Journal

基　　金：内蒙古医科大学“青年领创”项目(编号:2020066)。

摘　　要：目的 分析冠脉搭桥术后患者心电图T波改变与心室晚电位(VLP)的临床意义。方法 选取2020年8月至2021年8月在我院心外科行冠脉搭桥术的患者105例,完善常规心电图和心室晚电位检查后得出T波直立49例,T波倒置心室晚电位阳性56例(其中T波直立心室晚电位阳性38例,阳性率78%;T波倒置32例,阳性率57%),按照心室晚电位阳性将其分为T波直立心室晚电位阳性组(T1组)、T波倒置心室晚电位阳性组(T2组)。对两组进行乳酸脱氢酶、肌钙蛋白I、肌钙蛋白T、肌酸激酶、肌酸激酶同工酶、NT-BNP、左室舒张末期容积、左室收缩末期容积、射血分数检测并探讨与冠脉搭桥术后预后的相关性。结果 T_(1)组和T_(2)组VLP阳性率比较,差异有统计学意义(P<0.05)。两组间心肌酶检测结果比较差异无统计学意义。两组间射血分数比较差异有统计学意义(P<0.05)。NT-BNP、收缩末期容积、射血分数与T1组存在正相关关系(P<0.05)。结论 105例患者心室晚电位阳性率比较,T波直立患者心室晚电位阳性检出率明显高于T波倒置患者。NT-BNP、左室收缩末期容积、射血分数与T1组存在相关关系,进一步回归分析发现射血分数对T波直立患者更有检测意义。Objective To analyze the clinical significance of electrocardiographic T-wave changes and ventricular late potentials in patients after coronary artery bypass grafting.Methods A total of 105 patients who underwent coronary artery bypass grafting in our cardiac surgery department from August 2020 to August 2021 were selected,and 49 cases of T-wave upright and 56 cases of T-wave inverted were obtained after perfecting routine ECG and ventricular late potential examination(including 38 cases of positive T-wave upright ventricular late potential(78%positive rate)and 32 cases of T-wave inverted(57%positive rate),and they were divided into T-wave(T1 group)and T-wave inversion ventricular late potential positive group(T2 group).Lactate dehydrogenase,troponin I,troponin T,creatine kinase,creatine kinase isoenzyme,NT-BNP,left ventricular end-diastolic volume,left ventricular end-systolic volume,and ejection fraction were measured in both groups and correlated with the prognosis after coronary artery bypass grafting.Results There was no statistically significant difference in the positive rate of VLP between T1 group and T2 group(P>0.05).There was no statistically significant difference in the results of myocardial enzyme detection between the two groups.There was a statistically significant difference in Ejection fraction between the two groups(P<0.05).NT-BNP,end systolic volume,Ejection fraction and T1 were positively correlated(P<0.05).Conclusion The positive rate of ventricular late potentials in 105 patients was significantly higher in patients with upright T waves than in patients with inverted T waves.NT-BNP,left ventricular end-systolic volume,and ejection fraction were correlated with the T1 group,and further regression analysis revealed that ejection fraction was more detectable in patients with upright T waves.

关 键 词：冠脉搭桥术 心电图 心室 预后 

分 类 号：R540.4[医药卫生—心血管疾病]