aVR导联ST段抬高对非ST段抬高型急性心肌梗死的意义

doi:10.13308/j.issn.1008-0740.2014.06.011

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1006 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨aVR导联ST段抬高（ST segment elevation，STSE）对于非STSE型急性心肌梗死（acute myocardial infarction，AMI）的预测价值。方法回顾性分析425例非STSE型AMI患者的心电图资料，并观察各导联ST段压低情况及是否存在T波倒置。对所测定数据进行整理和统计学处理。结果 aVR导联STSE多见于完全性右束支阻滞、左心室肥厚以及V1导联STSE的患者，在其他导联广泛ST段压低的患者中也较为多见;此类情况在T波倒置患者中较少见。本研究中，22例在住院时死亡，其中5例死于心源性休克。患者住院死亡率的不断升高和aVR导联STSE的等级不断上升相关。多重变量分析表明，aVR导联STSE已经成为预测住院死亡的独立重要变量。aVR导联STSE大都与住院患者的心肌缺血时间以及发生心力衰竭相关，但是与血清肌酸激酶或肌酸激酶同工酶MB的水平高低没有相关性。结论如果aVR导联STSE和严重冠状动脉病变之间的联系，能够在大样本非STSE型AMI患者群体中得到进一步验证，那么aVR导联STSE就可以成为选择早期介入治疗患者的一个较为有用的指标。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	叶金枝
	周荣辉
	何青霞

关键词 ： aVR导联, ST段抬高, 非ST段抬高型急性心肌梗死, 急性心肌梗死

Abstract：Objective To study the predictive value of ST segment elevation(STSE) in aVR lead for non-STSE acute myocardial infarction(AMI).Methods The ECG data of 425 patients with non-STSE AMI were retrospectively analyzed, with ST depression in each lead and T-wave inversion observed. All the measured data were sorted out and statistically analyzed. Results STSE in aVR lead was more common in complete right bundle branch block, left ventricular hypertrophy and patients with STSE in V1 lead. And it is also popular in the patients with ST segment depression in other leads while it is rarely seen in the patients with T-wave inversion. In our study, 22 patients died during hospitalization, among whom 5 cases died of cardiogenic shock. The continuous increase of inhospital mortality was related to the ceaseless rise of STSE levels in aVR lead. Multivariate analysis showed that STSE in aVR lead had become an important independent variable for predicting inhospital mortality. STSE in aVR lead was mostly associated with inpatient' sduration of myocardial ischemia and heart failure, but was not related to levels of serum CK or CK-MB.Conclusion If the relationship between STSE in aVR lead and serious coronary artery disease can be verified in a large sample of nonSTSE AMI patients, STSE in aVR lead can serve as a quite useful index in judging which patient is feasible for interventional therapy in an early phase.

Key words： aVR lead ST segment elevation nonSTsegmentelevation acute myocardial infarction acute myocardial infarction

收稿日期: 2014-09-19

基金资助:

广东省江门市卫生计生局科研立项项目（14A004）

作者简介: 叶金枝，主治医师，主要从事心电图研究，E-mail：1589725541@qq.com

引用本文:

叶金枝, 周荣辉, 何青霞. aVR导联ST段抬高对非ST段抬高型急性心肌梗死的意义[J]. 实用心电学杂志, 2014, 23(6): 421-424. YE Jin-Zhi, ZHOU Rong-Hui, HE Qing-Xia. Predictive value of ST segment elevation in aVR lead for nonSTsegmentelevation acute myocardial infarction. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2014, 23(6): 421-424.

链接本文:

http://zzs.ujs.edu.cn/syxd/CN/10.13308/j.issn.1008-0740.2014.06.011 或 http://zzs.ujs.edu.cn/syxd/CN/Y2014/V23/I6/421

\[1\] 沈金强，魏来，夏利民，等.微创主动脉瓣置换术101例临床分析［J］.中华外科杂志，2013,51（3）：252-255.
\[2\] Astarci P，Price J，Glineur D,et al.Cerebral embolization during percutaneous valve implantation does not occur during balloon inflation valvuloplasty: prospective diffusionweighted brain MRI study\[J\]. J Heart Valve Dis,2013,22(1):79-84.
\[3\] 任静,李刚,门剑龙,等.非ST段抬高型心肌梗死患者非体外循环冠状动脉旁路移植术后的D二聚体测定\[J\].中华检验医学杂志,2014,37(3):222-226.
\[4\] 张优,高传玉,李牧蔚,等.早期应用替罗非班在急性ST段抬高型心肌梗死择期经皮冠状动脉介入治疗患者中的疗效\[J\].中华内科杂志,2014,53(4):273-277.
\[5\] 张嘉宁,张海柱,罗进光,等.瑞替普酶联合还原型谷胱甘肽治疗急性ST段抬高型心肌梗死的临床价值\[J\].中华老年医学杂志,2014,33(2):143-146.
\[6\] 齐静,姜钧文,陈韦,等.老年急性非ST段抬高心肌梗死合并心房颤动患者不同抗栓治疗方案对比研究\[J\].中华老年心脑血管病杂志,2014,16(3):248-251.
\[7\] 林文华,邸成业.T波形态在心律失常鉴别诊断中的作用\[J\].中华心律失常学杂志,2014,2(1):159-160.
\[8\] 郭筱燕,黄学成,王琦武,等.aVR导联对非ST段抬高型急性冠脉综合征冠状动脉病变的预测价值\[J\].岭南心血管病杂志,2014,20(1):44-47.
\[9\] 闫蕊.aVR导联ST段抬高对急性前壁心肌梗死相关罪犯血管的预测价值及预后评估\[J\].中西医结合心脑血管病杂志,2013,11(12):1454-1455.
\[10\] 李莉.aVR导联在急性心肌梗死诊断中的价值探讨\[J\].浙江临床医学,2013,1(8):1157-1158.
\[11\] 段续敏,胡桃红.急性心肌梗死aVR导联ST段抬高的临床意义\[J\].中国心血管病研究,2013,11(9):701-704.
\[12\] 沈健.aVR导联的临床价值\[J\].心血管病学进展,2013,34(3):423-426.