心电图在预测急性下壁心肌梗死罪犯血管中的应用  

Application of electrocardiogram in predicting culprit vessels in acute inferior myocardial infarction

作　　者：马源秋子 刘锋 李华康 陈彦秀 蔡晓莲 MA Yuan-qiu-zi;LIU Feng;LI Hua-kang;CHEN Yan-xiu;CAI Xiao-lian(Health Management Center,First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of Cardiovascular Medicine,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院健康管理中心,重庆400038 [2]陆军军医大学第一附属医院心血管内科,重庆400038

出　　处：《局解手术学杂志》2024年第5期440-444,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市科卫联合医学科研项目面上项目(2023MSXM146)。

摘　　要：目的探讨心电图预测急性下壁心肌梗死罪犯血管的价值。方法回顾性分析2015年1月至2021年12月陆军军医大学第一附属医院收治的129例急性下壁心肌梗死患者的临床资料,患者采用冠状动脉介入治疗,术中行冠状动脉造影确定罪犯血管。记录术中罪犯血管情况。分析患者术前心电图,基于以往研究建立心电图预测急性下壁心肌梗死罪犯血管的新方法,并统计Fiol法、Tierala法、黄氏算法和新方法预测急性下壁心肌梗死罪犯血管的准确性。采用受试者工作特征(ROC)曲线评估各种方法对罪犯血管的预测能力,计算曲线下面积(AUC)。结果109例患者罪犯血管为右冠状动脉,16例为回旋支,4例为前降支。52例患者出现临床合并症,罪犯血管为右冠状动脉47例,为回旋支5例。Fiol法、Tierala法、黄氏算法和新方法预测罪犯血管的准确性分别为83.7%、81.4%、82.9%和85.3%。ROC曲线分析显示:Fiol法(AUC=0.941)、Tierala法(AUC=0.945)、黄氏算法(AUC=0.945)和新方法(AUC=0.964)均对罪犯血管具有较强的预测能力。结论对于急性下壁心肌梗死患者,运用Fiol法、Tierala法、黄氏算法和新方法对术前心电图进行分析,均对罪犯血管有较高的预测价值,其中新方法的预测价值更高。Objective To explore the value of electrocardiogram in predicting culprit vessels in acute inferior myocardial infarction.Methods The clinical data of 129 patients with acute inferior myocardial infarction admitted to First Affiliated Hospital of Army Medical University from January 2015 to December 2021 were retrospectively analyzed.Patients were received coronary intervention treatment,and the culprit vessels were identified by coronary angiography.The culprit vessels during surgery were recorded.The preoperative electrocardio-gram of patients were analyzed,a new method for predicting culprit vessels in acute inferior myocardial infarction was established based on the previous researches,and the accuracies of the Fiol method,Tiala method,Huang's algorithm and new method in predicting the culprit vessels in acute inferior myocardial infarction were also counted.The predictive abilities of various methods on culprit vessels were evaluated using receiver operating characteristic(ROC)curve and the area under the curve(AUC)was calculated.Results The culprit vessels of 109 patients were the right coronary artery,16 cases were the left circumflex artery,and 4 cases were the anterior descending artery.A total of 52 patients developed clinical complications,of which the culprit vessels of 47 cases were right coronary artery and 5 cases were circumflex artery.The accuracies of the Fiol method,Tierala method,Huang's algorithm,and new method in predicting culprit vessels were 83.7%,81.4%,82.9%,and 85.3%,respectively.The ROC curve analysis showed that the Fiol method(AUC=0.941),Tierrala method(AUC=0.945),Huang's algorithm(AUC=0.945),and new method(AUC=0.964)all had strong predictive ability for culprit vessels.Conclusion For patients with acute inferior myocardial infarction,the Fiol method,Tierala method,Huang's algorithm,and new method all have high predictive value for culprit vessels in analyzing the preoperative electrocardiogram,and the new method has a higher predictive value.

关 键 词：心电图 心肌梗死 罪犯血管 右冠状动脉 左回旋支 

分 类 号：R541.4[医药卫生—心血管疾病]