心电图aVR导联的直立T波在急性非ST段抬高心肌梗死患者介入治疗评估中的应用

Application of Positive T Wave in Lead aVR of Electrocardiogram in Evaluation of Patients with Acute Non ST Segment Elevation Myocardial Infarction after Interventional Therapy

目的:探讨心电图aVR导联的直立T波,对急性非ST段抬高型心肌梗死(NSTEMI)患者介入治疗预后的评估价值.方法:选取2020年1月至2021年12月在本院诊断并行介入治疗的105例NSTEMI患者为研究对象.按照随访期内是否发生MACCE,将其分别纳入预后不良组(n=24)和预后良好组(n=81).采取回顾性分析,采集两组患者随访1年的临床病例资料,以不良心脑血管事件(MACCE)作为随访终点事件.比较不同预后情况的NSTEMI患者临床资料以及T波方向,分析心电图aVR导联的直立T波对患者预后不良风险的评估价值.结果:随访过程中,24例患者发生MACCE,MACCE发生率为22.86%(24/105).预后不良组aVR导联T波为直立T波方向占比,高于预后良好组,差异有统计学意义(P<0.05);两组患者其他资料比较,差异无显著差异(P>0.05).采取多因素非条件Logistic回归分析结果显示,aVR导联T波方向为直立T波是导致NSTEMI患者预后不良有关的独立危险因素(OR=8.038,95%CI:2.703~23.908,P<0.05).结论:心电图aVR导联的直立T波与NSTEMI患者介入治疗后预后不良有一定关系,对其预后评估具有重要临床价值.

Objective:To explore the evaluation effect of upright T wave in aVR lead of electrocardiogram on the prognosis of interventional treatment in patients with acute non ST segment elevation myocardial infarction(NSTEMI).Methods:A total of 105 NSTEMI patients diagnosed and treated with interventional therapy at our hospital from January 2020 to December 2021 were selected as the study subjects.According to whether the major adverse cardiac and cerebrovascular event(MACCE)occurred during the follow-up period,they were included in the poor prognosis group(n=24)and the good prognosis group(n=81).Retrospective analysis was used to collect clinical case data from two groups of patients were followed up for 1 year,with adverse cardiovascular and cerebrovascular events(MACCE)as the follow-up endpoint.The clinical data and T-wave direction of NSTEMI patients with different prognostic conditions were compared to analyze the value of vertical T-wave of aVR leads in evaluating the risk of adverse prognosis of patients.Results:According to the 1-year follow-up data of 105 NSTEMI patients,24 patients developed MACCE after surgery,with an incidence rate of 22.86%(24/105).The proportion of upright T-wave direction in aVR leads in the poor prognosis group was higher than that in the good prognosis group,and the difference was statistically significant(P<0.05).There was no significant difference in other data between groups(P>0.05).Through Logistic regression analysis,it was found that the upright T wave direction in aVR lead is associated with poor prognosis in NSTEMI patients(OR=8.038,95%CI:2.703~23.908,P<0.05).Conclusion:The positive T wave in lead aVR of electrocardiogram is related to the poor prognosis of NSTEMI patients after interventional therapy,which has predictive value on their prognosis.