心电图aVR导联ST段抬高对心肌梗死患者冠状动脉狭窄部位及心功能的评估价值

Value of ST segment elevation in lead aVR of electrocardiogram in the assessment of coronary artery stenosis and cardiac function of patients with myocardial infarction

目的探讨心电图aVR导联ST段抬高对心肌梗死患者冠状动脉狭窄部位及其心功能的评估价值。方法回顾性分析聊城市第三人民医院2018年1月至2019年1月收治的75例心肌梗死患者的临床资料,根据入选者心电图aVR导联ST段是否抬高,将其分为ST段抬高组(n=26)与非ST段抬高组(n=49),对比分析两组患者冠状动脉狭窄部位、心功能指标及心血管事件的发生情况。结果经检查,ST段抬高组患者冠状动脉狭窄部位在左主干、左前降支近端占比高于非ST段抬高组患者,左前降支远端占比低于非ST段抬高组患者,差异有统计学意义(P<0.05);ST段抬高组患者6 min步行距离短于非ST段抬高组患者,差异有统计学意义(P<0.05);左心射血分数(LVEF)低于非ST段抬高组患者,差异有统计学意义(P<0.05);ST段抬高组患者左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)值高于非ST段抬高组患者,差异有统计学意义(P<0.05);ST段抬高组患者心血管事件总发生率高于非ST段抬高组患者,差异有统计学意义(P<0.05)。结论心电图aVR导联ST段抬高能够有效判断心肌梗死患者冠状动脉狭窄部位,可为临床诊断及治疗提供有效参考依据。

Objective To evaluate the effect of ST segment elevation in lead aVR of electrocardiogram in the assessment of coronary artery stenosis and cardiac function of patients with myocardial infarction.Methods The clinical data of 75 patients with myocardial infarction admitted to the Third People’s Hospital of Liaocheng from January 2018 to January 2019 were analyzed retrospectively, according to the ST segment elevation of aVR lead, the participants were divided into ST segment elevation group (n=26) and non ST segment elevation group (n=49), the location of coronary artery stenosis, cardiac function index and the occurrence of cardiovascular events were compared between the two groups.Results According to the examination, the proportion of coronary artery stenosis in the left main trunk and the proximal part of left anterior descending artery in ST segment elevation group was higher than that in non ST segment elevation group, and the proportion of the distal part of left anterior descending artery was lower than that in non ST segment elevation group (P<0.05);6-minute walking distance of ST segment elevation group was shorter than that of non ST segment elevation group (P<0.05);left ventricular ejection fraction (LVEF) was lower than that of non ST elevation group (P<0.05);the values of left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDd) in ST segment elevation group were significantly higher than those in non ST segment elevation group (P<0.05);the total incidence of cardiovascular events in ST elevation group was higher than that in non ST elevation group (P<0.05).Conclusions ST segment elevation in lead aVR of ECG can effectively judge the location of coronary artery stenosis in patients with myocardial infarction, and provide effective reference for clinical diagnosis and treatment.