简介:摘要目的探究心电图aVR导联ST段改变在急性心肌梗死预测中的临床价值。方法选取2014年3月至2016年3月间的急性心肌梗死(AMI)患者137例,所有患者均符合急性心肌梗死的诊断标准,对患者进行十二导联心电图检查,并行冠状动脉造影确定梗死血管。结果在137例患者中抬高组患者有30例,未偏移组患者有79例,压低组患者有28例。抬高组、压低组患者在单支及三支病变血管中的发生率与未偏移组相比,差异具有统计学意义(P<0.05);抬高组左前降支近段及左主干病变比例高于压低组及未偏移组,压低组右冠状动脉支及左回旋支病变比例高于抬高组及未偏移组,差异有统计学意义(P<0.05);抬高组、压低组患者的临床不良心血管发生率均高于未偏移组,差异有统计学意义(P<0.05)。结论急性心肌梗死患者的心电图检查中,aVR导联中ST段抬高或压低对患者的病变数量、病变血管的位置及患者不良心血管事件的发生情况均具有重要的预测意义。
简介:BackgroundNon-ST-segmentelevationacutecoronarysyndrome(NSTE-ACS)isanacuteheartdiseasecausedbyincompleteocclusionofrelatedcoronaryarterieswithunstableatheroscleroticplaques.LeadaVRSTsegmentelevationandcTnIpositivearecloselycorrelatedtotheprognosisofNSTE-ACSpatients.However,therearefewstudiesapplyingthetwopredictorstoearlyriskstratificationinNSTE-ACSpatients.MethodTwohundredandfivecasesofNSTE-ACSpatientsfollowedupfor6monthsafterdischargewerereviewed.Allpatientsweredividedintofourgroups:GroupA-cTnInegativecombinedwithaVR-non-ST-segmentelevationgroup(100cases);GroupB-cTnInegativecombinedwithaVR-ST-segmentelevationgroup(31cases);GroupC-cTnIpositivecombinedwithaVR-non-ST-segmentelevationgroup(43cases);GroupD-cTnIpositivecombinedwithaVR-ST-segmentelevationgroup(31cases).Therewasnosignificantdifferenceingender,age,oldmyocardialinfarction,previousPCIhistory,hypertension,anddiabetesbetweenaVR-STelevationgroupandnoaVR-STelevationgroup.Themorbidityofleftmainorthree-vesselcoronaryarterydiseaseaswellasadversecardiovasculareventsinthefourgroupswereobservedandanalyzed.Results(i)Themorbidityofleftmainorthree-vesselcoronaryarterydiseasewashighestinGroupD(87.1%),andwasmarkedlyhigherinGroupB(41.9%)thanthatinGroupA(7%)orGroupC(9.3%);(ii)TheincidenceofadversecardiovasculareventswashighestinGroupD(77.4%),andwasmuchhigherinB(35.5%)ascomparedwiththattinGroupA(1%)orgroupC(7%).ConclusionElectrocardiographicleadaVRST-segmentelevationcombinedwithcTnIpositivehasanimportantclinicalvalueinpredictingtheprognosisofthepatientswithNSTE-ACS.