OCT和冠脉造影在冠心病介入诊疗过程中对心电图的影响

发布时间：2018-04-20 03:13

本文选题：冠心病 + CAG　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:在冠心病介入诊疗过程中,通过对体表心电图各波形的动态监测,对比分析OCT与冠脉造影这两种成像技术对心电图变化的影响。方法:选取2015-09至2017-01就诊于我院的冠状动脉硬化患者共134例,随机分为两组,一组为CAG组(n=98),即在CAG成像技术指导下进行介入诊疗,另一组为OCT组(n=36),即在CAG成像技术指导下进行介入诊疗并行OCT检查。在介入诊疗过程中,通过对体表心电图的动态监测,以QRS波群(R波振幅和QRS间期)、ST-T的改变为监测指标进行统计学分析,将各组间的数据采用SPSS17.0统计软件进行差异性分析,以P0.05为差异有统计学意义,对比分析OCT和CAG在CHD介入诊疗过程中对心电图的影响。结果:1基础资料对比:分别对两组患者入院资料进行统计,包括性别、年龄、体重、高血压、糖尿病、高脂血症,结果P值均0.05,无统计学差异。2 CAG组在注射造影剂后,出现R波振幅降低或升高的32例,QRS间期增宽的25例,ST段压低或降低、抬高或升高的共72例,T波振幅降低或倒置加深的68例,此外,有18例发生缓慢性心律失常,表现为窦性心动过缓,5例发生快速性心律失常,表现为室性心动过速。OCT组在注射造影剂后,出现R波振幅降低或升高的11例,QRS间期增宽的9例,ST段压低或降低、抬高或升高的共26例,T波振幅降低或倒置加深的24例,有3例发生缓慢性心律失常,表现为窦性心动过缓,1例发生快速性心律失常,表现为室性心动过速。组间对比ECG的变化率:(1)R波振幅变化率,CAG组和OCT组32.7%vs30.6%,P=0.818,无统计学差异;(2)QRS间期变化率,CAG组和OCT组25.5%vs25%,P=0.952,无统计学差异;(3)ST段变化率,CAG组和OCT组73.5%vs72.2%,P=0.885,无统计学差异;(4)T波振幅变化率,CAG组和OCT组69.4%vs66.7%,P=0.763,无统计学差异;(5)心率减慢,CAG组和OCT组18.4%vs8.3%,P=0.157,无统计学差异;(6)室速,CAG组和OCT组5.1%vs2.8%,P=0.564,无统计学差异。结论:在CHD介入诊疗过程中,尽管OCT检查需要注入更多的造影剂并且推注速度更快,但是OCT和CAG一样会出现QRS波群变化、ST段压低(或降低)或者抬高(或升高)、T波振幅降低或倒置加深、缓慢性或快速性心律失常,它们的变化率无显著差异,所以,OCT检查与CAG对心电图的影响无差异。
[Abstract]:Objective: in the process of interventional diagnosis and treatment of coronary heart disease, through dynamic monitoring of the various waveforms of the body surface electrocardiogram, the effects of the two imaging techniques of OCT and coronary angiography on the changes of electrocardiogram were compared and analyzed. Methods: 134 cases of coronary arteriosclerosis in our hospital were selected from 2015-09 to 2017-01, and were randomly divided into two groups, one group of CAG (n=98), or C Under the guidance of AG imaging technology, the other group is OCT group (n=36), that is, intervention diagnosis and treatment of OCT under the guidance of CAG imaging technology. In the process of interventional diagnosis and treatment, the dynamic monitoring of the body surface electrocardiogram, QRS wave group (R wave amplitude and QRS interval), ST-T change as the monitoring index, the statistical analysis is carried out between each group. The data were analyzed with SPSS17.0 statistical software, and the difference between P0.05 and OCT was statistically significant. The effects of OCT and CAG on the electrocardiogram were compared and analyzed. Results: 1 basic data were compared: the data of admission to two groups of patients were statistically analyzed, including sex, age, weight, hypertension, diabetes, hyperlipidemia, and results. The value of P was 0.05. There was no statistical difference in 32 cases of R wave amplitude reduction or elevation after injection of contrast agent in group.2 CAG, 25 cases of QRS interval widening, 72 cases of lower or lower ST segment, elevation or elevation, 68 cases of T wave amplitude decreasing or inversion deepening, and 18 cases with slow chronic arrhythmia, manifested as sinus bradycardia, 5 cases developed fast. Tachyarrhythmia, 11 cases of R wave amplitude decrease or increase after injection of contrast agent in.OCT group, 9 cases of QRS interval widening, 26 cases of ST segment depression or depression, 26 cases of elevation or elevation, 24 cases of T wave amplitude decreasing or inversion deepening, 3 cases with slow arrhythmia, sinus bradycardia, 1 case Rapid arrhythmia, showing ventricular tachycardia. The rate of change of ECG between groups: (1) R wave amplitude change rate, CAG group and OCT group 32.7%vs30.6%, P=0.818, no statistical difference; (2) QRS interval change rate, CAG group and OCT group 25.5%vs25%, P=0.952, no statistical difference; (3) ST segment change rate, no statistics, statistics, statistics, no statistics (4) T wave amplitude change rate, CAG group and OCT group 69.4%vs66.7%, P=0.763, no statistical difference; (5) heart rate slowed, CAG group and OCT group 18.4%vs8.3%, P=0.157, no statistical difference; (6) ventricular tachycardia, CAG group and OCT group 5.1%vs2.8%, no statistical difference. And the speed of pushing is faster, but OCT and CAG will appear QRS wave group changes, ST segment depression (or decrease) or elevation (or elevation), T wave amplitude decrease or inversion deepen, slow or rapid arrhythmia, their change rate has no significant difference, so OCT examination and CAG have no difference on electrocardiogram.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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