中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
7期
704-707
,共4页
赵成军%虞华鹏%姜婕%马圣庭%卢琳%贾如意
趙成軍%虞華鵬%薑婕%馬聖庭%盧琳%賈如意
조성군%우화붕%강첩%마골정%로림%가여의
缺血性J波%斑块类型%急性冠状动脉综合征%多血管病变
缺血性J波%斑塊類型%急性冠狀動脈綜閤徵%多血管病變
결혈성J파%반괴류형%급성관상동맥종합정%다혈관병변
Ischemic J wave%Plaque types%Acute coronary syndrome%Multivessel disease
目的 探讨急性冠状动脉综合征(ACS)伴缺血性J波患者冠状动脉病变特点.方法 将60例动态心电图发现缺血性J波的ACS患者(缺血性J波组)和60例动态心电图没有发现缺血性J波的ACS患者(非缺血性J波组)行冠状动脉造影检查,依据Genisini评分积分法判断狭窄的程度,将冠状动脉积分分为0分,1~80分,81～160分三个等级;依据Ambrose分法将斑块形态分为Ⅰ、Ⅱ、Ⅲ型.观察ACS伴缺血性J波患者冠状动脉病变特点以及斑块特点.结果 2组患者冠状动脉狭窄程度(U=3.0686,P=0.0022)、冠状动脉斑块类型的分布(x2=16.0890,P=0.0003),以及冠状动脉血管病变支教的分布差异有统计学意义(x2=12.1045,P=0.0024);缺血性J渡与冠状动脉狭窄程度、冠状动脉斑块类型、冠状动脉病变支数均有相关性(r=0.44,0.34,0.31;P均<0.05).结论 ACS伴缺血性J波患者冠状动脉狭窄程度重,多支血管病变发病率高,存在不稳定斑块的概率高,缺血性J波可作为心肌缺血超急性期的缺血改变的预测指标.
目的 探討急性冠狀動脈綜閤徵(ACS)伴缺血性J波患者冠狀動脈病變特點.方法 將60例動態心電圖髮現缺血性J波的ACS患者(缺血性J波組)和60例動態心電圖沒有髮現缺血性J波的ACS患者(非缺血性J波組)行冠狀動脈造影檢查,依據Genisini評分積分法判斷狹窄的程度,將冠狀動脈積分分為0分,1~80分,81～160分三箇等級;依據Ambrose分法將斑塊形態分為Ⅰ、Ⅱ、Ⅲ型.觀察ACS伴缺血性J波患者冠狀動脈病變特點以及斑塊特點.結果 2組患者冠狀動脈狹窄程度(U=3.0686,P=0.0022)、冠狀動脈斑塊類型的分佈(x2=16.0890,P=0.0003),以及冠狀動脈血管病變支教的分佈差異有統計學意義(x2=12.1045,P=0.0024);缺血性J渡與冠狀動脈狹窄程度、冠狀動脈斑塊類型、冠狀動脈病變支數均有相關性(r=0.44,0.34,0.31;P均<0.05).結論 ACS伴缺血性J波患者冠狀動脈狹窄程度重,多支血管病變髮病率高,存在不穩定斑塊的概率高,缺血性J波可作為心肌缺血超急性期的缺血改變的預測指標.
목적 탐토급성관상동맥종합정(ACS)반결혈성J파환자관상동맥병변특점.방법 장60례동태심전도발현결혈성J파적ACS환자(결혈성J파조)화60례동태심전도몰유발현결혈성J파적ACS환자(비결혈성J파조)행관상동맥조영검사,의거Genisini평분적분법판단협착적정도,장관상동맥적분분위0분,1~80분,81～160분삼개등급;의거Ambrose분법장반괴형태분위Ⅰ、Ⅱ、Ⅲ형.관찰ACS반결혈성J파환자관상동맥병변특점이급반괴특점.결과 2조환자관상동맥협착정도(U=3.0686,P=0.0022)、관상동맥반괴류형적분포(x2=16.0890,P=0.0003),이급관상동맥혈관병변지교적분포차이유통계학의의(x2=12.1045,P=0.0024);결혈성J도여관상동맥협착정도、관상동맥반괴류형、관상동맥병변지수균유상관성(r=0.44,0.34,0.31;P균<0.05).결론 ACS반결혈성J파환자관상동맥협착정도중,다지혈관병변발병솔고,존재불은정반괴적개솔고,결혈성J파가작위심기결혈초급성기적결혈개변적예측지표.
Objective To understand the coronary characteristic of acute coronary syndrome patients with ischemic J wave. Methods Comparison was made between 60 acute coronary syndrome patients with ischemic J wave and 60 acute coronary syndrome patients without ischemic J wave. All patients were examined by Holter monitoring electrocardiogram and coronary arteriongraphy. To distinguish the stenosis degree was defined in three degree based on Genisini score of 0, 1-80, and 81-160. Plaque types were divided into Ⅰ,Ⅱ, Ⅲ by Ambrose classification,the coronary and plaque characteristics of acute coronary patients were observed with ischemic J wave. Results There were no significant difference of stenosis degree between the two groups ( U = 3. 0686, P = 0. 0022), whereas there were significant difference of plaque types (x2 =16. 0890, P = 0. 0003) and coronary vessel numbers(x2 =12. 1045, P = 0. 0024). The degree of stenosis, the plaque types, and number of stent in coronary vessel were positively correlated with ischemic J wave(r =0. 44,0. 34,0. 31 ;P <0. 05). Conclusions The acute coronary syndrome with ischemic J wave patients is often not only accompanied with serious coronary stenosis and high incidence rate of multivessel disease,but also high probability of unstabilized plaque. Ischemic J wave can be a predictor of super-acute ischemic of myocardium.
