心电图aVR T波形态联合DFR预测急性ST段抬高型心肌梗死介入治疗预后的相关性研究  

Correlation study of electrocardiogram aVR T wave morphology combined with DFR on predicting the prognosis of acute ST-segment elevation myocardial infarction undergoing interventional therapy

作　　者：韩娟娟 袁燕 张风雷 HAN Juan-juan;YUAN Yan;ZHANG Feng-lei(Department of Special Inspection,Dongying People's Hospital,Dongying 257091,Shandong,China;Department of Cardiology,Dongying People's Hospital,Dongying 257091,Shandong,China)

机构地区：[1]东营市人民医院特检科,山东东营257091 [2]东营市人民医院心内科,山东东营257091

出　　处：《川北医学院学报》2023年第9期1218-1221,共4页Journal of North Sichuan Medical College

基　　金：山东省医药卫生科技发展计划项目(202103010741)。

摘　　要：目的:探讨心电图aVR T波形态联合D-二聚体/纤维蛋白原比值(DFR)与急性ST段抬高型心肌梗死(ASTEMI)介入治疗患者预后的关系。方法:选取98例ASTEMI介入治疗患者为研究对象,根据患者术后6个月是否发生主要心血管不良事件(MACE)分为MACE组(n=19)和非MACE组(n=79)。分析影响预后的影响因素及心电图aVR T波形态联合DFR对预测ASTEMI介入治疗患者预后的临床价值。结果:MACE组心电图aVR导联T波直立所占比例、LVEF、LVESD、LVFS及D-二聚体、纤维蛋白原、DFR水平均高于非MACE组(P<0.05);Spearman相关性分析显示,T波形态、LVESD值、D-二聚体水平及DFR值与MACE的发生均呈正相关(P<0.05);Logistics回归分析显示,T波形态、LVESD值、D-二聚体水平及DFR值均为ASTEMI患者介入术后发生MACE的独立危险因素(P<0.05);ROC曲线显示,T波形态、DFR预测ASTEMI介入治疗患者预后的曲线下面积(AUC)分别为0.774、0.672,二者联合预测的AUC为0.851,联合预测价值更高。结论:心电图aVR T波形态和DFR水平与ASTEMI介入治疗患者预后相关,且是独立危险因素,二者联合对患者预后具有较高的预测价值。Objective:To explore the relationship between electrocardiogram aVR T wave morphology combined with D-dimer/fibrinogen ratio(DFR)and prognosis of patients with acute ST-segment elevation myocardial infarction(ASTEMI)undergoing interventional therapy.Methods:98 patients with ASTEMI undergoing interventional therapy were selected as the research subjects.According to the prognosis[occurrence of major adverse cardiovascular events(MACE)at 6 months after surgery],the patients were divided into MACE group(n=19)and non-MACE group(n=79).The influencing factors affecting the prognosis and the clinical value of electrocardiogram aVR T wave morphology combined with DFR on predicting the prognosis of ASTEMI undergoing interventional therapy were analyzed.Results:The proportion of electrocardiogram aVR lead T-wave upright,LVEF,LVESD,LVFS,D-dimer,fibrinogen and DFR in MACE group were higher than those in non-MACE group(P<0.05).Spearman analysis revealed that T wave morphology,LVESD,D-dimer level and DFR were positively correlated with the occurrence of MACE(P<0.05).Logistics regression analysis showed that T wave morphology,LVESD,D-dimer and DFR were independent risk factors for MACE occurrence in patients with ASTEMI after interventional therapy(P<0.05).ROC curve showed that the area under curve(AUC)of T wave morphology and DFR in predicting the prognosis of patients with ASTEMI undergoing interventional therapy were 0.774 and 0.672,respectively,and the AUC of the combined prediction was 0.851,which had higher predictive value.Conclusion:Electrocardiogram aVR T wave morphology and DFR are associated with prognosis of patients with ASTEMI undergoing interventional therapy,and are independent risk factors.The combination of the two has high predictive value on prognosis.

关 键 词：急性ST段抬高型心肌梗死 介入治疗 心电图 AVR导联 T波形态 D-二聚体/纤维蛋白原比值 预后 

分 类 号：R542.2[医药卫生—心血管疾病]