冠心病冠状动脉搭桥术后心电图的动态变化

The dynamic changes of electrocardiogram before and post coronary artery bypass surgery in patients with coronary heart disease

目的 探讨冠心病冠状动脉搭桥术 (CABG)后心电图的动态变化。方法 回顾性比较 2 9例冠心病 CABG成功者术前与术后 1周、2～ 3周、2月及 3月等不同阶段 12导联心电图的变化。结果 与术前 (5 .6± 2 .6天 )比较 ,异常 Q波和 T波低平、双向的发生在术后第 1周显著增多 (16 .7%与 11.5 % ,P<0 .0 5 ,8.0 %与 2 .6 % ,P<0 .0 1) ,此后 ,异常 Q波的发生显著减少 (P<0 .0 5 ) ,T波低平或双向的发生则持续到第 2～ 3周后恢复到术前水平。 ST段压低 >1.0 m m和 T波倒置在术后第 2～ 3周、第 2月显著增多(5 .5 %、6 .3%与 2 .3% ,P<0 .0 5 ;31.3%、2 7.0 %与 17.8% ,P<0 .0 1) ,此后 ST段压低者减少到术前水平 ,T波倒置非常显著地减少 (9.2 %与 17.8% ,P<0 .0 1)。结论 冠心病病人 CABG术后出现早期一过性异常 Q波、T波低平或双向、ST段压低变化 ,此后上述改变逐渐减少恢复到术前水平。

Objectives To study the dynamic changes of elcetrocardiogram before and post coronary artery bypass surgery (CABG) on patients with coronary heart disease.Methods 12 leads ECGs were taken and compared before,1 week,2 to 3 weeks,2 months and 3 months post successful CABG in 29 patients.Results Abnormal Q wave,flat T wave and T reversion were significantly increased in the first week comparing to pre-CABG(16.7% vs.11.5%, P <0 05 and 8.0% vs.2.6%, P <0 01) T wave changes lasted for 2 to 3 weeks and 2 months post CABG(5.5%,6.3% vs.2.3%, P <0 01,respectively).These changes of ST segment and T wave were decreased to pre-CABG levels and even less.Conclusion There are a transient changes of ECG including abnormal Q wave,flat T wave,T reversion and ST segment depression in patients post CABG.