心电图aVR导联对急性非ST段抬高型心肌梗死的病变血管的预测价值及预后评估

隗沫; 顾伟; 李昭; 王雪; 钟洁

doi:10.13201/j.issn.1009-5918.2021.07.010

心电图aVR导联对急性非ST段抬高型心肌梗死的病变血管的预测价值及预后评估

- 清华大学附属垂杨柳医院急诊医学中心(北京, 100022)

详细信息

通讯作者: 顾伟,E-mail:banditgu@163.com

中图分类号: R542.2

收稿日期: 2021-04-10

The predictive value and prognosis evaluation of electrocardiogram aVR lead in the diseased vessels of acute non-ST-segment elevation myocardial infarction

- Emergency Medicine Center, Chuiyangliu Hospital Affiliated to Tsinghua University, Beijing, 100022, China

More Information

Corresponding author: GU Wei, E-mail: banditgu@163.com

Received Date: 10 April 2021

摘要

摘要: 目的:探讨心电图aVR导联对急性非ST段抬高型心肌梗死(NSTEMI)病变血管的预测价值及预后评估。方法:选取2019年6月—2021年2月期间清华大学附属垂杨柳医院急诊科收治的100例NSTEMI患者作为研究对象,按照aVR导联ST段改变情况,将ST段抬高0.5~1.0 mm的24例患者纳入A组,将ST段抬高>1.0 mm的26例患者纳入B组,将ST段无抬高的50例患者纳入C组,所有研究对象均完成冠脉造影检查或介入治疗,对3组冠状动脉病变发生率、血管梗死部位、心血管不良事件发生率进行比较并分析。结果:A、B组发生单支冠状动脉病变例数明显少于C组,发生三支冠脉病变例数多于C组,差异有统计学意义(P<0.05);B组发生左前降支、左主干梗死数高于A、C两组,差异有统计学意义(P<0.05)。B组心力衰竭发生率多于A、C组;A组再发心梗发生率明显多于B、C组,差异有统计学意义(P<0.05)。结论:aVR导联中ST改变情况与冠脉病变数量及血管梗死位置有一定的相关性;ST段无抬高的NSTEMI患者冠脉病变数量及血管病变程度较低,同时其发生心力衰竭、再发心梗的心血管不良事件风险较低;而ST段抬高幅度明显的患者冠脉病变程度相对更严重,预后更差。
- aVR导联 /
- 急性心肌梗死 /
- 心电图 /
- 预测
Abstract: Objective: To investigate the predictive value and post-predictive value of aVR lead electrocardiogram in patients with acute non-ST-elevation type of myocardial infarction(NSTEMI).Methods: A total of 100 patients with NSTEMI who were admitted to Department of Emergency, Tsinghua University Affiliated Chuiyangliu Hospital from June 2019 to February 2021 were selected as the study subjects. According to the change of ST segment in lead aVR, 24 patients with ST segment elevation of 0.5 to 1.0 mm were included in group A, 26 patients with ST segment elevation greater than 1.0 mm were included in group B, and 50 patients without ST segment deviation were included in group C. All patients completed coronary angiography or interventional therapy, and the incidence of coronary artery disease, infarct location and major adverse cardiovascular events(MACE) of the three groups were compared and analyzed.Results: The number of single coronary artery disease in group A and B was significantly less than that in group C, and the number of three-vessel coronary artery disease was more than that in group C, the difference was statistically significant(P<0.05); the number of left anterior descending artery and left main artery infarction in group B was higher than that in group A and C, the difference was statistically significant(P<0.05); the incidence of heart failure in group B was higher than that in group A and C; the incidence of recurrent myocardial infarction in group A was significantly higher than that in group B and C, and the difference was statistically significant(P<0.05).Conclusion: The changes of ST in lead aVR are related to the number of coronary artery lesions and the location of vascular infarction; NSTEMI patients with no ST-segment elevation have a lower number of coronary artery disease and the degree of vascular disease. At the same time, they have a lower risk of cardiovascular adverse events such as heart failure and recurrent myocardial infarction; while patients with significant ST segment elevation have more severe coronary artery disease and a worse prognosis.
- aVR lead /
- acute myocardial infarction /
- electrocardiogram /
- prediction

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