四川医学2016，Vol.37Issue(4)：399-403,5.DOI:10.16252/j.cnki.issn1004-0501-2016.04.012
冠状动脉内心电图ST段改变对冠心病患者PCI相关心肌损伤判断价值
Diagnostic Value of Intracoronary Electrocardiogram ST-segment Change for Percutaneous Coronary Intervention ;related Myocardial Injury in patients with Coronary Heart Disease
李迪 1刘剑雄 2徐俊波 3胡咏梅 3聂晓莉 3李秋 3曾朝荣 3曾智3
作者信息
- 1. 四川大学华西医院，四川 成都610041
- 2. 成都市第二人民医院心内科，四川 成都610017
- 3. 成都市第二人民医院心内科，四川 成都610017
- 折叠
摘要
Abstract
Objective To evaluate the diagnostic value of intracoronary electrocardiogram( IC-ECG) ST-segment change for percutaneous coronary intervention(PCI) related myocardial injury/infarction(PMI). Methods 65consecutive patients with stable or unstable angina scheduled for percutaneous coronary intervention were enrolled. Before intervention and 6, 12, 18 and 24 hours after intervention, serum cardiac troponin T( cTnT) levels were tested. And we recorded the IC-ECG ST-segment changes during interventions. The PMI group was defined as cTnT≥0. 1ng/mL after PCI. And the none-PMI group was defined as cTnT<0. 1ng/mL. The intraoperative and postoperative chest pain, cardiac events during 1 to 6-month postoperative follow-up were recor-ded. Results All 65 patients’ serum cTnT levels located in the normal range before interventions. Significant intraoperative IC-ECG ST-segment changes(ST-segment change≥0. 1mv) manifested in 24 patients(change group), and the other 41 patients did not show significant changes in IC-ECG ST-segment(control group). After PCI, PMI was detected in 30 patients, and 22(91. 7%) of them showed significant intraoperative ST-segment change. While among the other 35 patients whose serum cTnT <0. 1ng/ml, only 2 (5. 71%) cases of significant ST-segment change was detected during the PCI. Significant difference was demonstrated by the Chi-square test( =31. 714,P<0. 001). And Logistic regression analysis showed that intraoperative IC-ECG ST-segment change was an independent predictive factor for myocardial injury[OR=70. 314, 95%CI]6. 175,800. 657), P=0. 001]. Conclusion IC-ECG is an effective method for predicting PMI. And IC-ECG ST-segment change can simultaneously and accurately monitor PMI.关键词
冠状动脉介入治疗/心肌损伤/冠状动脉内心电图Key words
percutaneous coronary intervention/myocardial injury/intracoronary electrocardiogram分类
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李迪,刘剑雄,徐俊波,胡咏梅,聂晓莉,李秋,曾朝荣,曾智..冠状动脉内心电图ST段改变对冠心病患者PCI相关心肌损伤判断价值[J].四川医学,2016,37(4):399-403,5.
