冠状动脉造影剂注射对心电图的影响

Effects of injection of contrast medium on parameters of electrocardiogram during coronary angiography

目的探讨冠心病患者冠状动脉造影剂注射对心电图QRS时间及QRS额面电轴的影响。方法观察34例经冠状动脉造影确诊为左冠状动脉狭窄而右冠状动脉无病变的冠心病患者 ,注射造影剂前后QRS时间和额面电轴的变化。结果左冠状动脉注射造影剂后QRS时间延长 (86.23±8.53ms比94.09±11.18ms,P<0.01) ,QRS额面电轴左偏或有左偏趋势 (42.76°±18.43°比22.74°±23.16°,P<0.01) ;右冠状动脉注射造影剂后 ,QRS时间无明显变化 (P>0.05) ,QRS额面电轴右偏或有右偏趋势 (42.76°±18.43°比53.62°±17.69°,P<0.05)。结论注射造影剂后QRS时间延长及QRS额面电轴的变化可能是急性心肌缺血的标志。

Department of Cardiology,Yunyang Medical College Affiliated Hospital, Shiyan 442000, Hubei (*Departnent of Cardiology, Affiliated Hospital No. 2,Chongqing Medical University,Chongqing) Objective To investigate effects of contrast medium injection on QRS duration and frontal plane QRS axis during coronary angiography. Methods QRS duration and frontal plane QRS axis were measured before and after injection of contrast medium in 34 patients with left coronary artery disease identified by coronary angiography. Results QRS duration was prolonged(86.23±8.53 ms比94.09±11.18 ms,P<0.01)and frontal plane QRS axis was prone to or shifted to left(42.76°±18.43°比22.74°±23.16°,P<0.01)after injection of contrast medium in left coronary artery,QRS duration was no difference(P>0.05) and frontal plane QRS axis was prone to or shifted to right(42.76°±18.43°比53.62°±17.69°,P<0.05)after injection contrast medium in right coronary artery. Conclusion QRS prolongation and frontal plane QRS axis deviation after contrast medium injection may be a marker of myocardial ischemia.