体表心电图对冠脉左主干病变患者短期预后的预测价值

目的评价冠脉左主干病变致急性心肌梗死住院患者短期预后体表心电图的预测价值。方法 41例接受再灌注治疗的冠脉左主干病变致急性心肌梗死住院患者均做全导心电图,讲心电图结果按存活组和死亡组分为两组。结果因冠脉左主干病变致心肌梗死的患者在30天的随访期中,有24例死亡,17例存活。死亡组中体表心电图aVR和aVL导联ST段均较存活组抬高(54%vs 18%,P<0.05),左前分支阻滞(83%vs 41%,P<0.05)和右束支阻滞(54%vs 18%,P<0.05)更常见,但V5导联ST段压低(17%vs59%,P<0.05)则少见。结论对因冠脉左主干病变致心肌梗死的住院患者,体表心电图对其短期预后预测有一定价值。

Electrocardiographic prediction of short-term prognosis in patients with acute myocardial infarction associated with the left main coronary artery

Objective To assess the value of electrocardiogram to predict short-term prognosis in patients with acute myocardial infarction（AMI） associated with left main coronary artery（LMCA）.Methods Electrocardiogram was obtained in 41 patients with AMI associated with LMCA who underwent reperfusion therapy.Electrocardiographic findings were compared between nonsurvivor group and survivor group.Results There were 24 nonsurvivors and 17 survivors during 30-day follow-up.Nonsurvivors had ST-segment elevation in both leads aVR and aVL（54% vs 18%,P〈0.05）,more frequent left anterior fascicular block（83% vs 41%,P〈0.05）,and right bundle-branch block（54% vs 18%,P〈0.05）,and less frequent ST-segment depression in lead V5（17% vs 59%,P〈0.05） than survivors did.Conclusion Our data suggest that electrocardiogram on admission might be useful to predict short-term prognosis in patients with AMI associated with LMCA.