论文部分内容阅读
目的:探讨冠状动脉(冠脉)急性完全闭塞的急性冠脉综合征(ACS)患者入院心电图的不典型改变,以便尽快做出侵入性治疗策略。方法:回顾性分析2014-01-2017-02于我院导管室行急诊PCI的1支主要冠脉急性完全闭塞患者168例,根据入院时心电图是否有典型改变分为2组:典型改变组156例(符合急性ST段抬高型心肌梗死典型心电图改变)和非典型改变组12例(表现为心电图无改变或ST段压低/T波倒置、低平)。了解3支主要冠脉闭塞的发生率、典型心电图改变发生率,不典型心电图改变发生率及其分布情况,记录患者进入急诊室大门到冠脉球囊扩张的时间(D-TO-B)和出院时左室射血分数(LVEF)。结果:168例患者冠脉闭塞性病变部位中,首先位于左前降支88例,其次为右冠脉58例,冠脉左回旋支22例;其中非典型改变组分别为5例(5.7%)、3例(5.2%)、4例(18.2%)。典型改变组D-TO-B时间为(2.75±0.76)h,非典型改变组为(3.54±0.80)h。左前降支闭塞患者中,非典型改变组较典型改变组EF值明显降低。结论:非典型改变组D-To-B时间明显延长,前降支闭塞非典型改变组心功能明显降低,所以早期识别有助于尽早采取侵入性治疗策略。
Objective: To investigate the atypical changes of admissions electrocardiogram in acute coronary syndrome (ACS) patients with acute complete occlusion of coronary artery (coronary artery) in order to make invasive treatment strategy as soon as possible. Methods: A retrospective analysis of 168 patients with acute coronary artery occlusion in our hospital from January 2016 to February 2016 in our hospital was performed. According to whether there were typical changes of electrocardiogram on admission, the patients were divided into two groups: typical group 156 Cases (in line with the typical ECG changes of acute ST-elevation myocardial infarction) and atypical change group of 12 cases (showed no change of ECG or ST segment depression / T wave inversion, low level). To understand the incidence of three major coronary occlusions, the incidence of typical ECG changes, the incidence of atypical electrocardiogram changes and their distribution, and record the time (D-TO-B) and Left ventricular ejection fraction (LVEF) at discharge. Results: Of the 168 patients with coronary artery occlusion, 88 were located in the left anterior descending coronary artery, followed by 58 in the right coronary artery and 22 in the left circumflex coronary artery. Among them, 5 (5.7% , 3 cases (5.2%) and 4 cases (18.2%). The typical time to D-TO-B was (2.75 ± 0.76) h in the typical group and (3.54 ± 0.80) h in the atypical group. Among the patients with left anterior descending coronary artery occlusion, the EF of the atypical change group was significantly lower than that of the typical change group. CONCLUSION: The D-To-B time of atypical change group is obviously prolonged. The cardiac function of atypical change group of anterior descending aorta occlusion is significantly reduced. Therefore, early recognition can help to take invasive treatment as soon as possible.