缺血性J波与急性冠脉综合征病变相关性分析

Relationship between Ischemic J Wave and Acute Coronary Syndrome

目的探讨缺血性J波与冠状动脉狭窄程度以及冠状动脉斑块类型之间的关系。方法将60例动态心电图发现缺血性J波的急性冠脉综合征患者和60例动态心电图没有发现缺血性J波的急性冠脉综合征患者行冠状动脉造影检查,依据冠状动脉狭窄处的积分来判断狭窄的程度。0～4分为Ⅰ度,5～8分为Ⅱ度,≥8分为Ⅲ度;依据Am-brose分法将斑块形态分为Ⅰ、Ⅱ、Ⅲ型。分析冠状动脉狭窄程度与冠状动脉斑块类型与缺血性J波的关系。结果两组患者冠状动脉狭窄程度间差异无统计学意义(u=0.02,P=0.98);两组患者冠状动脉斑块类型的分布间差异有统计学意义(χ2=16.09,P=0.0003);缺血性J波与冠状动脉狭窄程度无相关性(r=0.24,P>0.05),缺血性J波与冠状动脉病变类型呈正相关性(r=0.34,P<0.05)。结论冠状动脉Ⅱ型斑块以及冠状动脉中度狭窄的患者缺血性J波发生率高,可作为心肌缺血超急性期缺血改变的预测指标。

Objective To investigate the relationship of ischemic J wave to coronary artery （CA） plaque types and coronary artery stenosis （CAS） . Methods Coronary angiography was performed in 60 acute coronary syndrome patients with ECG isehemie J - wave and 60 without. The degrees of stenosis were judged according to the CAS scores, taking 0 - 4 as degree I, 5 -8 as degree II, ≥8 as degree Ⅲ, and plaque morphology divided into types I, II, III based on Ambrose law, to analyze the relationship of isehemic J wave to CAS degrees and CA plaque types. Results There was not significant difference in CAS degree between 2 groups （u =0. 0195, P =0. 9845） , but there was in distribution of CA plaque （χ^2 = 16. 0890, P =0. 0003）. Ischemic J wave was not correlated with CAS degree （ r = 0. 24, P 〉 0.05 ） , but positively correlated with CA lesion type （ r = 0. 34, P 〈 0. 05 ） . Conclusion Patients with type II plaques or middle - degree CAS have a high incidence of ischemic J wave, which can be used as a predictor for ischemie changes of super - acute phase of myocardial ischemia.