冠状动脉内支架置入术前后心电图的变化

Changes of ECG criteria before and after intracoronary stent placement for coronary heart disease

目的 :探讨冠状动脉性心脏病 (简称冠心病 )时冠状动脉内支架置入术前后心电图的变化规律。 方法 :回顾性研究分析 1 36例冠心病冠状动脉内支架置入术前后的心电图资料及冠状动脉造影 (CAG)资料。 结果 :1 36例患者中 ,1 0 8例术后心电图发生改变 ,占 79.4 1 %。不同病变范围组的心电图改变差异无显著性意义 (P >0 .0 5 ) ,该研究分别从临床症状、诊断冠状动脉的优势类型、病变部位及手术前后累及导联数的改变等几个方面 ,具体探讨了不同病变范围组之间在介入手术前、后的心电图变化。结果提示 ,二支病变时急性冠状动脉综合征 (ACS)和非ACS患者支架置入前后的心电图改变有统计学意义 (P <0 .0 2 5 ) ,单支病变时 ,典型胸痛、不典型胸痛及无胸痛者置入支架后心电图改变差异有显著性意义 (P <0 .0 5 ) ,心电图有改变者术前、术后导联数对比分析结果 ,在单支、二支及多支病变组中差异均有显著性意义 (P <0 .0 0 1 )。 结论 :通过观察手术前后心电图的改变 。

Objective:To explore the changes of ECG criteria before and after intracoronary stent placement for coronary heart disease(CHD). Methods:Retrospective analysis was performed in 136 patients with CHD by comparing the findings of ECG before and after intracoronary stent placement and CAG. Results:In 108 of 136 patients(79.41%), the ECG changed manifestations were different, the change was little among the different lesion scopes of the coronary artery ( P >0.05).The criteria changes of ECG before and after operation was particularly studied among different lesion scopes of the coronary artery, according to the clinical diagnosis, clinical symptom, the dominated coronary artery, location of the lesion and leads with changes before and after intracoronary stent placement. The results were as follows: the changes of ECG criteria between group of ACS and group of non ACS had significance when lesion envolved two vessels ( P <0.025). When lesion was single vessel involved happening among group of those with typical chest pain,atypical chest pain and no chest pain ,the changes was obvious as well( P < 0.05). The result of ECG changes investigated by comparative analysis of the leads involved before and after operation showed that the difference was extremely prominent among group of single vessel lesion, two vessel lesion and the multiple vessel lesion in patients with CHD( P <0.001). Conclusion:The ECG criteria changes before and after intracoronary stent placement for CHD can provide the information about the functional improvement of the myocardial blood flow after stem placement.