心肌梗死患者aVR导联T波与冠脉病变的相关性研究

目的] 探讨aVR导联T波方向与急性ST段抬高型心肌梗死患者冠脉病变程度的相关性.方法] 选择218例急性ST段抬高型心肌梗死患者临床资料,根据冠脉造影术前aVR导联T波方向,分为正向组(n=90)与非正向组(n=128),比较两组患者间梗死相关血管、病变血管支数、Gensini积分等指标.再根据aVR导联T波正向组冠脉介入治疗术后的T波恢复情况,将其分为恢复组与未恢复组,观察冠脉介入治疗对aVR导联T波恢复情况的影响.结果] T波正向组IRA前降支发生率高于T波非正向组,冠脉多支血管病变所占比例高于T波非正向组,侧支循环所占比例低于T波非正向组,组间比较差异均有统计学意义(均P<0.05).T波正向组Gensini积分轻度所占比例小于T波非正向组,重度所占比例高于T波非正向组,组间比较差异均有统计学意义(均P<0.05);aVR导联T波正向OR=1.67,95%CI(1.029~3.077),P=0.049<0.05] 、高龄OR=1.023,95%CI(1.009~1.042),P=0.045<0.05] 均是冠脉病变程度的危险因素;T波恢复组冠脉单支病变处理梗死相关血管(IRA)前降支所占比例显著高于T波未恢复组,PCI术前Gensini积分重度者所占比例显著低于T波未恢复组,差异均具有统计学意义(均P<0.05).结论] aVR导联T波方向与急性ST段抬高型心肌梗死患者冠脉病变程度相关.

Correlation between aVR Lead T Wave and Coronary Artery Lesions in Patients with Myocardial Infarction

Objective]To clarify the correlation between the T wave in lead aVR and the severity of coronary artery lesions in patient with ASTEMI.Methods]Clinical data of 218 patients with acute ST segment elevation myocardial infarction (ASTEMI)were divided into positive group (n=90) and non positive group (n=128) according to the aVR lead T wave direction before the coronary angiography.Comparison between two groups of infarction related artery vessel disease, Gensini score and other indicators were conducted.According to the recovery of T wave after percutaneous coronary intervention, the patients of aVR lead T wave positive group were divided into the recovery group and the non-recovery group.The effect of percutaneous coronary intervention on the recovery of T wave in aVR lead was observed.Results]The incident of IRA descending of the positive T wave group was higher than that of T non positive group, the proportion of multivessel lesions was higher than that of the non T positive group , the collateral circulation proportion was lower than that of the non T positive group,there was significant difference between the two groups (P<0.05);the Slight proportion of Gensini integral of the positive T wave group was less than that of non-positive T wave group,the Severe proportion was higher than that of non-positive T wave group, there was significant difference between the two groups (P<0.05);aVR lead T wave positive OR=1.67,95% CI (1.029~3.077),P=0.049<0.05], aged OR=1.023,95% CI (1.009~1.042),P=0.045<0.05]were all risk factors for coronary artery disease;The ratio of anterior descending branch of coronary artery (IRA) of single coronary artery lesion in the T wave recovery group was significantly higher than that of the T wave group;the proportion of patients with severe preoperative Gensini score of PCI was significantly lower than that of T wave group, the difference was statistically significant (P<0.05).Conclusion]The direction of T wave in aVR lead is correlated with the severity of coronary artery lesions in patients with acute ST segment elevation myocardial infarction.