摘要
目的心肌梗死是冠状动脉粥样硬化性心脏病的严重亚型,常伴发多种并发症,造成严重后果.本研究探讨动态心电图在不同冠状动脉病变的心肌梗死诊断中表现特点。方法选取2017-08-01-2019-03-20潢川县人民医院收治的80例心肌梗死患者为研究对象,患者均行动态心电图与冠动脉造影检查,统计患者动态心电图检查结果,结合冠动脉造影结果,分析单支、双支及多支冠动脉病者心律失常具体情况,并结合心电图以及冠动脉造影结果明确罪犯血管,分析不同罪犯血管心律失常具体情况。结果 80例心肌梗死患者动态心电图显示,心律失常79例(98.75%),室性心律失常52例(65.00%),对室性早搏25例(31.25%),频发室性早搏13例(16.25%),短阵室性心动过速12例(15.00%),心房纤颤7例(8.75%),室性逸搏3例(3.75%),RonT现象1例(1.25%),ⅡⅢ度房室传导阻滞1例(1.25%),窦性停搏1例(1.25%)。双支、单支和多支病变患者复杂或恶性心律失常发生率分别为72.73%、20.00%和51.02%,差异有统计学意义,χ^2=8.981,P=0.011;房性心律失常发生率分别为54.55%、35.00%和77.55%,差异有统计学意义,χ^2=11.450,P=0.003;左主干与前降支病变患者复杂或恶性心律失常发生率为69.77%,高于左回旋支(20.00%)和右冠状动脉病变患者(14.81%),差异有统计学意义,χ^2=22.833,P<0.001;房性心律失常发生率为81.40%,高于左回旋支(20.00%)和右冠状动脉病变患者(37.04%),差异有统计学意义,χ^2=20.291,P<0.001。结论动态心电图检查结果能够作为心肌梗死患者心律失常诊断的重要依据,可为心肌梗死病情程度评估以及预后判断提供参考。
OBJECTIVE Myocardial infarction is a serious subtype of coronary atherosclerotic heart disease,often accompanied by a variety of complications,causing serious consequences.This study explores the characteristics of dynamic electrocardiogram in the diagnosis of myocardial infarction in different coronary artery disease.METHODS A total of80 patients with myocardial infarction admitted to Huangchuan County People’s Hospital from August 01,2017 to March20,2017 were selected as the research subjects.All patients underwent dynamic electrocardiogram and coronary angiography.The patients’ dynamic electrocardiogram examination results were combined with coronary angiography,the specific situation of arrhythmia in patients with single,double and multiple coronary artery disease was analyzed,and the electrocardiogram and coronary angiography results were used to clarify the criminal vessels,and the specific situation of vascular arrhythmias of different criminals was analyzed.RESULTS Dynamic electrocardiogram of 80 patients with myocardial infarction showed that there were 79 cases of arrhythmias(98.75%),52 cases of ventricular arrhythmia(65.00%),25 cases of ventricular premature beats(31.25%),and 13 cases of frequent ventricular premature beats(16.25%),12 cases of short-term ventricular tachycardia(15.00%),7 cases of atrial fibrillation(8.75%),3 cases of ventricular escape(3.75%),1 case of RonT phenomenon(1.25%),Ⅱ-Ⅲ degree atrioventricular block in 1 case(1.25%)and sinus arrest in 1 case(1.25%).The incidence of complex or malignant arrhythmias in patients with dual,single,and multivessel disease were72.73%,20.00% and 51.02%,χ^2=8.981,P=0.011,and the incidence of atrial arrhythmias were 54.55%,35.00%and77.55%,χ^2=11.450,P=0.003.The incidence of complex or malignant arrhythmias in patients with left main and anterior descending branch disease was 69.77%,which was higher than the left circumflex branch(20.00%)and patients with right coronary artery disease(14.81%),χ^2=22.833,P<0.001.The incidence of atrial arrhythmia was 81.40%,which was higher than the left circumflex branch(20.00%)and right coronary artery disease patients(37.04%),χ^2=20.291,P<0.001.CONCLUSION The results of dynamic electrocardiogram can be used as an important basis for the diagnosis of arrhythmia in patients with myocardial infarction,and can provide reference value for the evaluation of the severity of myocardial infarction and the prognosis.
作者
吴燕
陈红娟
王磊
WU Yan;CHEN Hong-juan;WANG Lei(Department of ECG Room,Huangchuan People’s Hospital,Huangchuan 465150,P.R.China)
出处
《社区医学杂志》
2020年第6期405-408,共4页
Journal Of Community Medicine
关键词
心肌梗死
动态心电图
冠状动脉病变
单支
多支
myocardial infarction
dynamic electrocardiogram
coronary artery disease
single branch
multiple branch
作者简介
通信作者:吴燕,女,河南信阳人,主治医师,主要从事心电图相关的临床研究工作。E-mail:chen543657@163.com。
