Stanford A型急性主动脉夹层和急性冠状动脉综合征患者心电图分析

Analysis of electrocardiograph between acute aortic dissection Stanford type A and acute coronary syndrome

目的:研究Stanford A型急性主动脉夹层患者和急性冠状动脉综合征患者心电图表现的不同,为临床工作提供指导。方法:回顾我院Stanford A型急性主动脉夹层41例患者急性发病后、手术前心电图作为观察组,以急性冠状动脉综合征的50例患者作为对照组,比较两组患者心电图参数,寻找心电图的不同表现。结果:观察组患者存在QTc间期延长。进一步分析发现Stanford A型急性主动脉夹层患者QRS波较急性心肌梗死患者缩短,心肌复极时间(QTc-QRS)延长为主。比较Stanford A型急性主动脉夹层患者手术前后心脏彩超主动脉瓣上血流速度,术后患者血流速度减慢,后负荷减小,QTc间期缩短。结论:Stanford A型急性主动脉夹层患者存在QTc间期延长,其机制可能与心脏后负荷增加,心脏射血时间延长有关。以此为依据,计算心肌复极时间(QTc-QRS)可以作为鉴别诊断Stanford A型急性主动脉夹层患者和急性心肌梗死的辅助手段。

Objective: To study the difference of electrocardiograph between acute aortic dissection Stanford type A and acute coronary syndrome to direct the clinic work. Methods: Forty-one patients with acute aortic dissection Stanford type A were choose as observation group, and fifty patients were choose as control group. Through comparing the different between the two groups, to discover parameter with diagnosis value. Results: Observation group exists in prolong of QTc interval.Addational study discloses that QRS of patients with aortic dissection Stanford type A is short than acute coronary syndrome.Blood flow velocity at aortic valve of patients with aortic dissection Stanford type A is faster than acute coronary syndrome,which is changed after surgery. Conclusions: Patients with acute aortic dissection Stanford type A have a longer QTc interval, because their hearts undertake a more afterload which lead to a longer cardiac ejection time,so QTc-QRS can be as a method for differential diagnosis acute aortic dissection Stanford type A and acute coronary syndrome.