急性冠状动脉综合征心电图与冠状动脉造影的相关性分析

目的探讨急性冠状动脉综合征（ACS）患者临床心电图（ECG）与冠状动脉造影（CAG）诊断的相关性。方法对158例ACS患者的ECG、CAG资料进行回顾性对比分析。结果158例ACS患者中，145例冠状动脉存在有意义病变，13例未见明显病变；多支病变多于单支病变，且以中、重度狭窄为主；前壁急性心肌梗死（AAMI）以前降支（LAD）病变或合并多支血管病变为主，下壁急性心肌梗死（AIMI）以右冠状动脉（RCA）合并多支血管病变为主；不稳定型心绞痛（UA）的心电图sT段改变呈多样性，以sT下移和sT无变化为主；ST无变化者，以反映多支中、重度病变为多。结论ECG与相应冠状动脉存在关联性，可反映当时动脉粥样斑块破裂伴血栓形成、血流阻断血管的对应病变，但对多支病变的正确诊断率偏低，临床上需准确判读ECG，以给ACS治疗干预和进一步CAG提供依据。

Objective To investigate the correlation between ECG and CAG in diagnosis of ACS. Methods Analyze ECG and CAG of 158 patients with ACS. Results Among 158 patients with ACS, 145 patients＇ coronalT artery was found with significant stenosis, while 13 patients＇ was not found evident stenosis, and multi -vessel cases were more than single vessel cases, mainly in several vessels, and moderate, severe degree. AAMI was found mainly in LCA lesion with several other blood vessels lesions. AIMI was found mainly in RCA lesion together with several other vessecular lesions. ST - segment change of UA was various, cases with ST - segment depression and ST - segment without obvious change consisted the main cases. In UA with normal ECG, multi - vessel stenosis was often found. Conclusions ECG only indicates the corresponding lesion of obstructive vessels when artery atherosclerotic plaques rupture and thrombosis forms, but in a low rate of diagnosing multi - vessel disease correctly.