CAJ | 학술논문

目的：研究心电图对前壁ST段抬高型心肌梗死患者多支冠脉病变的预测效果。方法：选取2013年9月-2014年12月在本院进行治疗的急性心肌梗死患者88例，根据患者入院前的心电图和冠动脉影像资料将患者分为观察组和对照组，其中观察组确诊为多支冠脉病变，对照组只存在单支血管病变，其中包括观察组48例，对照组40例。分别将两组患者入院前的心电图和冠动脉影像资料进行对比分析，研究心电图对前壁ST段抬高型心肌梗死患者多支冠脉病变的预测效果。结果：两组ST段抬高患者中，aVL导联共22例，其中观察组13例，对照组9例；V6导联共38例，其中观察组27例，对照组11例，两组的ST段抬高心电图aVL导联和V6导联比较差异有统计学意义（P<0.05）。观察组的心电图ST段抬高程度与多支冠脉病变情况进行比较，均以左前降支为主，差异无统计学意义（P>0.05），心电图ST段抬高0.05~0.1 mV和>0.1 mV的三支病变比例比较差异有统计学意义（P<0.05）。ST抬高程度>0.1 mV比抬高0.05~0.1 mV敏感性好、准确性高、特异性相近且阴性预测价值较低、阳性预测价值较高。结论：心电图对前壁ST段抬高型心肌梗死患者多支冠脉病变具有较高的阳性预测价值，多支冠脉病变与前壁ST段抬高程度密切相关。
목적：연구심전도대전벽ST단태고형심기경사환자다지관맥병변적예측효과。방법：선취2013년9월-2014년12월재본원진행치료적급성심기경사환자88례，근거환자입원전적심전도화관동맥영상자료장환자분위관찰조화대조조，기중관찰조학진위다지관맥병변，대조조지존재단지혈관병변，기중포괄관찰조48례，대조조40례。분별장량조환자입원전적심전도화관동맥영상자료진행대비분석，연구심전도대전벽ST단태고형심기경사환자다지관맥병변적예측효과。결과：량조ST단태고환자중，aVL도련공22례，기중관찰조13례，대조조9례；V6도련공38례，기중관찰조27례，대조조11례，량조적ST단태고심전도aVL도련화V6도련비교차이유통계학의의（P<0.05）。관찰조적심전도ST단태고정도여다지관맥병변정황진행비교，균이좌전강지위주，차이무통계학의의（P>0.05），심전도ST단태고0.05~0.1 mV화>0.1 mV적삼지병변비례비교차이유통계학의의（P<0.05）。ST태고정도>0.1 mV비태고0.05~0.1 mV민감성호、준학성고、특이성상근차음성예측개치교저、양성예측개치교고。결론：심전도대전벽ST단태고형심기경사환자다지관맥병변구유교고적양성예측개치，다지관맥병변여전벽ST단태고정도밀절상관。
Objective:To study the prediction effect of ECG in patients of anterior wall myocardial infarction with ST segment elevation and multivessel coronary artery disease.Method:88 patients with acute myocardial infarction were treated in our hospital from September 2013 to December 2014,according to artery imaging data and ECG before admission,the patients were divided into observation group and control group, the observation group of 48 cases with multi vessel coronary artery disease, while the control group of 40 cases with a single vessel lesion. The ECG and coronary artery imaging data of two groups before admission were analyzed,the effect of prediction on electrocardiogram in patients with anterior wall myocardial infarction with ST segment elevation and multivessel coronary artery disease were observed. Result:In ST segment elevation of two groups,aVL lead a total of 22 cases,the observation group of 13 cases, control group of 9 cases; V6 lead a total of 38 cases, 27 cases in the observation group, 11 cases in the control group,compared the ECG of aVL lead and V6 lead, the differences were statistically significance(P<0.05). In the observation group, compared the degree of ST segment elevation and multiple coronary artery lesions,patients were mainly left anterior descending branch,the difference was no statistically significant(P>0.05).Compared three lesions of ST segment elevation in 0.05-0.1 mV and ST segment elevation>0.1 mV, the difference was statistically significant(P<0.05). The sensitivity,accuracy, and negative predictive value of ST elevation level>0.1 mV were better than the elevation of 0.05-0.1 mV, specificity was similar,the ST elevation level>0.1 mV of lower negative predictive value and higher positive predictive value.Conclusion:Electrocardiogram (ECG) on the front wall ST segment elevation myocardial infarction patients with multivessel coronary artery lesions has high positive predictive value, multivessel coronary artery disease is closely related to the degree of anterior wall ST segment elevation.