冠状动脉急性完全闭塞的不典型心电图分析

发布时间：2018-02-03 02:38

本文关键词： 急性冠脉综合征冠状动脉急性闭塞心电图　出处：《临床心血管病杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的:探讨冠状动脉(冠脉)急性完全闭塞的急性冠脉综合征(ACS)患者入院心电图的不典型改变,以便尽快做出侵入性治疗策略。方法:回顾性分析2014-01-2017-02于我院导管室行急诊PCI的1支主要冠脉急性完全闭塞患者168例,根据入院时心电图是否有典型改变分为2组:典型改变组156例(符合急性ST段抬高型心肌梗死典型心电图改变)和非典型改变组12例(表现为心电图无改变或ST段压低/T波倒置、低平)。了解3支主要冠脉闭塞的发生率、典型心电图改变发生率,不典型心电图改变发生率及其分布情况,记录患者进入急诊室大门到冠脉球囊扩张的时间(D-TO-B)和出院时左室射血分数(LVEF)。结果:168例患者冠脉闭塞性病变部位中,首先位于左前降支88例,其次为右冠脉58例,冠脉左回旋支22例;其中非典型改变组分别为5例(5.7%)、3例(5.2%)、4例(18.2%)。典型改变组D-TO-B时间为(2.75±0.76)h,非典型改变组为(3.54±0.80)h。左前降支闭塞患者中,非典型改变组较典型改变组EF值明显降低。结论:非典型改变组D-To-B时间明显延长,前降支闭塞非典型改变组心功能明显降低,所以早期识别有助于尽早采取侵入性治疗策略。
[Abstract]:Objective: to investigate the atypical changes of electrocardiogram (ECG) in patients with acute coronary syndrome (ACS) with acute total coronary occlusion (ACS). Methods: a retrospective analysis of 168 patients with acute total occlusion of a major coronary artery in emergency PCI in our hospital from 2014-01-2017-02 was carried out. According to whether there were typical changes in ECG at admission, the two groups were divided into two groups: 156 patients with typical changes (according with the typical ECG changes of acute ST-segment elevation myocardial infarction) and 12 patients with atypical changes. The electrocardiogram showed no change or St segment depression / T wave inversion. To understand the incidence of three main coronary artery occlusion, the incidence of typical ECG changes, the incidence of atypical ECG changes and their distribution. D-TO-Band left ventricular ejection fraction (LVEF) and left ventricular ejection fraction (LVEF) were recorded in 168 patients with coronary occlusive lesions. 88 cases were located in the left anterior descending branch, 58 cases in the right coronary artery and 22 cases in the left circumflex branch of the coronary artery. The D-TO-B time in the atypical change group was 2.75 卤0.76 hours, and the D-TO-B time in the typical change group was 2.75 卤0.76 hours. The atypical change group was 3. 54 卤0. 80 h. in patients with left anterior descending branch occlusion. Conclusion: D-To-B time in atypical change group was significantly longer than that in typical change group, and the cardiac function in atypical changes of anterior descending branch occlusion group was significantly lower than that in atypical change group. So early identification is helpful for early invasive therapy.
【作者单位】：丹阳市人民医院心内科;丹阳市人民医院超声科;
【基金】：江苏省镇江市卫生科技重点专项项目(No:SHW2015020)
【分类号】：R541.4
【正文快照】： 对于冠状动脉(冠脉)急性闭塞,我国及美国心ST段压低/T波倒置、低平)。脏病学会(ACC)和美国心脏协会(AHA)指南均要1.2　方法求尽快实现再灌注,以挽救频临坏死的心肌,保护以入院后首份心电图作为标准,所有患者就诊心功能,改善预后。在此过程中,心血管内科或急后立即做12导联心电

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