心肌梗死患者不同冠状动脉病变的动态心电图研究

Study on dynamic electrocardiogram of different coronary artery lesions in myocardial infarction

目的探讨心肌梗死不同冠状动脉病变患者动态心电图心律失常的发生情况,为临床抗心律失常方案的选择提供依据。方法回顾性分析自2013年1月~2016年1月于北京地坛医院接受动态心电图检查以及冠状动脉造影检查的81例心肌梗死患者的临床资料。统计上述患者发生心律失常的情况;对比冠状动脉单支病变、双支病变以及多支病变患者心律失常的发生情况;对比不同罪犯血管心律失常的发生情况。结果 81例心肌梗死患者中,心律失常发生率为98.77%,其中71例出现房性心律失常,54例出现室性心律失常。复杂或者恶性心律失常在双支病变患者中的发生率为66.67%,多支病变患者的发生率为52.00%,均显著高于单支病变患者的发生率(P均<0.05);房性心律失常在多支病变患者中的发生率为78.00%,显著高于单支病变和双支病变患者的发生率(P均<0.05)。左主干及前降支病变复杂或者恶性心律失常的发生率为68.89%,房性心律失常的发生率为80.00%,均显著高于左回旋支和右冠状动脉病变的发生率(P均<0.05)。结论动态心电图可作为诊断心肌梗死后心律失常的重要依据,同时有助于评估心肌梗死的严重程度,对判断预后有一定的参考价值。

Objective To investigate the occurrence of arrhythmia in myocardial infarction patients withdifferent coronary artery lesions,and to provide the basis for the selection of clinical anti arrhythmia program.Methods The clinical data of81patients with myocardial infarction from January2013to January2016were analyzed.Single coronary artery lesions,double stenosis and multi vessel disease in patients with arrhythmia occurrence were compared,and different criminal vessel arrhythmia situation were compared.Results The incidence of arrhythmia was98.77%in81patients with myocardial infarction.There were71patients of atrial arrhythmia,54patients of ventricular arrhythmia.Incidence rate of complex or malignant arrhythmia was66.67%in patients with double vessel disease,and it was52%in patients with multivessel disease,which were significantly higher than that of single vessel disease incidence rate(P<0.05).The incidence rate of atrial arrhythmia was78%in patients with multivessel disease,which was significantly higher than that in patients with single vessel and double vessel disease(P<0.05).Incidence rate of left main coronary artery and anterior descending artery complex or malignant arrhythmia was68.89%,and the incidence of atrial arrhythmias was80%,which were significantly higher than that of the left circumflex and right coronary artery disease(P<0.05).Conclusion The dynamic ECG can be used as an important basis for the diagnosis of myocardial infarction after myocardial infarction,it can help to assess the severity of myocardial infarction,and have a certain reference value for prognosis.