冠状动脉内心电图ST段改变对冠心病患者PCI相关心肌损伤判断价值

Value of ST Segment Changes in Coronary Electrocardiogram in Judging PCI-related Myocardial Injury in Patients with Coronary Heart Disease

目的:研究冠状动脉内心电图ST段改变对冠心病患者PCI相关心肌损伤的判断价值。方法:纳入80例患者作为此次研究的对象,纳入时间段为2018年2月~2019年2月,所有患者均在本院确诊为冠心病并接受PCI治疗,在术前及术后分别测定患者cTnT(血清心肌钙)的水平,同时记录患者手术过程中心电图ST段的改变情况,术后,c TnT平均水平≥0.1ng/mL的患者判断为心肌损伤,纳为损伤组,而cTnT<0.1ng/mL的患者判断为无心肌损伤情况,纳为无损伤组。通过多因素回归分析判断ST段改变对冠心病患者PCI相关心肌损伤的影响情况。结果:患者术前的cTnT水平均正常,30例(37.5%)患者在术中表现为ST段改变阳性(有意义的ST段改变),50例(62.5%)患者表现为ST段改变阴性(无意义的ST段改变);术后,损伤组37例(46.25%),其中27例(72.91%)为ST段改变阳性,无损伤组43例(53.75%),其中3例(6.98%)为ST段改变阳性,组间差异显著(P<0.05);多因素回归分析结果显示,ST段改变阳性是心肌损伤的独立预测因素(P<0.05)。结论:冠心病PCI患者术中心电图ST段的改变对其相关心肌损伤有着准确、敏感的监测价值,可作为判断PCI患者心肌损伤的经济、有效的方法。

Objective:To study the judgment value of the changes of ST segment in the electrocardiogram of coronary arteries on PCI-related myocardial injury in patients with coronary heart disease.Methods:Eighty patients were included as the object of this study.The inclusion period was from February 2018 to February 2019.All patients were diagnosed with coronary heart disease in our hospital and received PCI treatment,and were measured before and after surgery.The level of cTnT(serum myocardial calcium)in the patient,and the changes in the ST segment of the central electrogram during the operation were recorded.Postoperatively,patients with an average cTnT level≥0.1ng/mL were judged to be myocardial injury,which was regarded as the injury group,and cTnT<0.1 Patients at ng/mL were judged to have no myocardial injury and were admitted to the non-injury group.Multivariate regression analysis was used to determine the effect of ST segment changes on PCI-related myocardial injury in patients with coronary heart disease.Results:The cTnT level was normal before surgery.30 patients(37.5%)showed positive ST-segment changes(meaningful ST-segment changes),and 50(62.5%)patients showed negative ST-segment changes(Insignificant ST segment changes);postoperatively,37 cases(46.25%)of the injury group,of which 27(72.91%)were positive for ST segment changes,43 cases(53.75%)of the non-injury group,of which 3(6.98%)Positive ST-segment changes were significant(P<0.05).Multivariate regression analysis showed that positive ST-segment changes were independent predictors of myocardial injury(P<0.05).Conclusion:The change of ST segment of electrocardiogram in patients with coronary heart disease PCI has accurate and sensitive monitoring value for related myocardial injury,and it can be used as an economical and effective method for judging myocardial injury in patients with PCI.