入院心电图对心肌梗死患者多支冠脉病变诊断价值.docVIP

入院心电图对心肌梗死患者多支冠脉病变诊断价值 　　[摘要] 目的 探讨入院心电图对心肌梗死患者多支冠脉病变诊断价值。 方法 整群收集2013年2月―2014年12月该院急诊科就诊的220例前壁STEMI患者，患者均接受心电图检查和冠脉造影检查，分为下壁导联ST段抬高组68例，下壁导联ST段降低组152例。分析两组患者中心电图特征在单支冠脉病变和多支冠脉病变中的分布差异情况。结果 下壁导联ST段降低时，aVL、V6导联出现ST段降低与多支血管病变明显相关，这种心电图特征所占比例在累及左前降支的多支病变患者中明显高于单支病变患者（P0.05）。结论 入院心动图变化对AMI患者多支冠脉病变具有一定的预测作用，通过下壁导联ST段改变可一定程度反映梗死相关动脉是左前降支或回旋支，还是右冠脉主干中之一。 　　[Abstract] Objective To discuss the diagnostic value of admission electrocardiogram for coronary multiple-branch lesions in patients with myocardial infarction. Methods 220 cases of patients with anterior wall STEMI treated in the emergency department of our hospital from February 2013 to December 2014 were collected and were given electrocardiography and coronary arteriography and divided into ST segment elevation in inferior wall leads group with 68 cases and ST segment depression in inferior wall leads group with 152 cases， the distribution difference of electrocardiogram characteristics in the coronary single-branch lesions and coronary multiple-branch lesions of the two groups was analyzed. Results ST segment depression was obviously correlated with multi-vessel disease inaVL andV6 leads at the time of ST segment elevation in inferior wall leads， the proportion of these electrocardiogram characteristics in patients with multi-vessel lesions involving left anterior descending branch was obviously higher than that in the single-vessel lesions（P0.05）. Conclusion Admission kinetocardiogram change plays a certain predictive role in coronary multiple-branch lesions of AMI patients， and ST segment changes in inferior wall leads can reflect the infarction related artery is left anterior descending branch， left circumflex artery or one of right coronary artery backbones. 　　[Key words] Electrocardiogram； Myocardial infarction； Coronary multiple-branch lesions 　　冠心病是临床常见的一种心血管疾病，好发于老年患者，对患者的身心健康造成严重的影响。目前，冠状动脉造影是冠心病诊断主要手段，但该检查方法受多种因素影响，且对患者产生辐射损伤，致使大部分患者无法耐受。近期，随着心电图技术的不断完善，心电图检查逐渐应用于心血管相关疾病的诊断中，由于其具有无创、可反复复查，费用低廉、操作简