【摘要】 目的研究急性冠脉综合征(ACS)三支病变患者心电图表现。方法 241例冠状动脉(冠脉)造影明确的ACS分成非ST段抬高型急性冠脉综合征(NSTE-ACS)(n=173)与急性ST段抬高型心肌梗死(STEMI)(n=68)两种群体,比较各群体中三支病变与非三支病变患者心电图指标。结果 NSTEMI-ACS三支病变与左主干病变患者多表现为V4～V6、Ⅰ、Ⅱ导联ST段压低伴随aVR导联ST段抬高的心电图模式。与STEMI非三支病变患者相比,STEMI三支病变患者I、aVL、V6导联ST段抬高数占比较多,且多有aVR导联T波直立与低电压表现;冠脉造影提示STEMI三支病变患者右冠及左回旋支狭窄程度更重。结论 NSTEMI-ACS三支病变与左主干病变患者具有相对特定的心电图表现,STEMI三支病变患者心肌梗死部位广泛,易合并侧壁心肌梗死。更多还原

【Abstract】 Objective To study the electrocardiogram of patients with three branches of acute coronary syndrome(ACS). Methods 241 coronary angiography-defined ACS were divided into two groups: non-ST-segment elevation acute coronary syndrome(NSTE-ACS)(n=173) and acute ST-segment elevation myocardial infarction(STEMI)(n=68). The electrocardiogram indexes of patients with three branches and non-three branches in each group were compared. Results Most patients with NSTEMI-ACS three-segment lesions and left main lesions showed ECG patterns of ST segment depression in leads V4～V6, I and Ⅱ accompanied by ST segment elevation in lead aVR. Compared with patients with non-three-vessel disease of STEMI, patients with three-vessel disease of STEMI had more ST-segment elevations in leads Ⅰ, aVL and V6, and there were more T-wave upright and low-voltage performance in lead aVR; coronary angiography suggested STEMI The right coronary artery and left circumflex branch stenosis were more severe in patients with three branches. Conclusion Patients with NSTEMI-ACS three-segment lesions and left main lesions have relatively specific electrocardiographic findings. Patients with STEMI three-segment lesions have extensive myocardial infarction sites and are likely to have lateral wall myocardial infarction.更多还原