实用心电与临床诊疗2025，Vol.34Issue(1)：36-39,47,5.DOI:10.13308/j.issn.2097-5716.2025.01.008
非ST段抬高型心肌梗死伴罪犯血管闭塞患者心电图征象及诊断价值
ECG signs and diagnostic value in patients with non-ST-segment elevation myocardial infarction complicating culprit vessel occlusion
摘要
Abstract
Objective To investigate the ECG signs and their diagnostic value in patients with non-ST-segment elevation myocardial infarction(NSTEMI)complicating culprit vessel occlusion.Methods A total of 113 NSTEMI patients were selected,and divided into vascular occlusion group(50 cases)and non-vascular occlusion group(63 cases)according to the presence or absence of vascular occlusion.We analyzed the ECG signs of patients in the two groups,including the number of leads with ST-segment depression(STD),the maximum value of STD(STDmax),the amplitude of ST-segment in lead aVF,aVR and aVL,and the proportion of patients with pathological Q-wave,isolated STD and poor R-wave progression.We also analyzed the coronary angiography features[the left anterior descending branch(LAD),left circumflex branch(LCX),right coronary artery(RCA),and others].ROC curve analysis was used to explore the diagnostic value of ECG parameters for NSTEMI with culprit vessel occlusion.Results The sex,age,time of onset,diabetes and other general data did not vary signifiantly between the two groups(all P>0.05).There were statistically significant differences in the proportion of hypertension,hyperlipidemia and culprit vessels between the two groups(all P<0.05).Compared with the non-vascular occlusion group,the number of STD leads,STDmax,the amplitude of ST-segment in lead aVF and aVR,and the proportion of patients with pathological Q-wave or isolated STD in the vascular occlusion group were greater,all with statistically significant differences(all P<0.05).The AUC values of the number of STD leads,STDmax,the amplitude of ST-segment in lead aVF,the amplitude of ST-segment in lead aVR,and the combined examination in the diagnosis of NSTEMI with culprit vessel occlusion were 0.662(0.560-0.764),0.814(0.734-0.893),0.691(0.594-0.788),0.673(0.572-0.774)and 0.864(0.799-0.929),respectively;the sensitivity was 58.00%,84.00%,88.00%,70.00%and 92.00%,respectively;the specificity was 68.30%,73.00%,54.00%,63.50%and 69.80%,respectively.Conclusion Among the NSTEMI patients with culprit vessel occlusion,the number of STD leads was greater,while the proportion of patients with pathological Q-wave or isolated STD was higher.The sensitivity of the combined ECG signs is relatively high in the diagnosis of NSTEMI with culprit vessel occlusion,which could provide important references for the detection,diagnosis and treatment of NSTEMI with culprit vessel occlusion in clinical practice.关键词
非ST段抬高型心肌梗死/罪犯血管闭塞/心电图征象/诊断价值Key words
non-ST-segment elevation myocardial infarction/culprit vessel occlusion/ECG sign/diagnostic value分类
临床医学引用本文复制引用
罗艳华,王艳敏,徐燕爽,叶卉..非ST段抬高型心肌梗死伴罪犯血管闭塞患者心电图征象及诊断价值[J].实用心电与临床诊疗,2025,34(1):36-39,47,5.基金项目
河南省中医药传承与创新人才工程(仲景工程)中医药拔尖人才项目(豫卫中医函[2021]15 号) （仲景工程）
