急性冠脉综合征患者aVR导联ST段变化与冠状动脉Gensini评分的相关性研究

Relationship between ST-segment changes of lead aVR and Gensini score in patients with acut coronary syndrome

目的探讨急性冠脉综合征患者a VR导联ST段变化与冠状动脉Gensini评分的相关性,从而评价冠状动脉病变的严重程度,并评估其预后。方法对129例急性冠脉综合征患者的体表心电图和冠脉造影资料进行回顾性对比分析,其中STa VR抬高组69例,STa VR无抬高组60例。结果 STa VR抬高组中左冠状动脉主干(LM)病变、左前降支(LAD)病变及三支病变的发生率显著高于STa VR无抬高组(分别为28.99%比5.00%,P<0.01;72.46%比40.00%,P<0.01;43.48%比15.00%,P<0.01)。STa VR抬高组患者的冠状动脉Gensini评分明显高于STa VR无抬高组[(84.69±31.19)分比(46.76±26.89)分,P<0.01]。STa VR抬高组患者住院期间心脏不良事件的发生率高于STa VR无抬高组(17.39%比5.00%,P<0.05)。STa VR变化与冠状动脉Gensini评分呈明显的正相关(r=0.625,P<0.01)。结论急性冠状动脉综合征时,体表心电图的a VR导联ST段变化对冠状动脉病变程度有重要的预测价值。

Objective To investigate the relationship between ST-segment changes of lead aVR and Gensini score in patients with acut coronary syndrome（ ACS） ,then to evaluate the severity of coronary artery disease and assess the prognosis. Methods The data of ECG and coronary angiographic findings in 129 patients with ACS were comparatively analyzed,including 69 cases with STaVR elevation and 60 cases without STaVR elevation. Results In the STaVR elevation group,the prevalence of left main（ LM） ,left anterior descending （LAD）and 3-vessel coronary artery disease was significantly higher than those in the group without STaVR elevation（28. 99% versus 5. 00%,P〈0. 01;72. 46% versus 40. 00%,P〈0. 01;43. 48% versus 15. 00%,P〈0. 01）. Higher Gensini score and higher inci-dence of adverse cardiac events in the the group with STaVR elevation[（84.69 ±31.19）versus（46.76 ±26.89）,P〈0.01;17.39%versus 5. 00%,P〈0. 05]. Changes of STaVR and Gensini score was correlative（r=0. 625,P〈0. 01）. Conclusion In patients with ACS,the ST segment changes in lead aVR have important predictive value of coronary artery stenosis.