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目的分析心电图检出心律失常与冠状动脉病变关系,为急性心肌梗死诊治、预后提供参考。方法选取我院120例急性心肌梗死患者为研究对象,所有患者均行动态心电图检测和冠状动脉造影,记录心律失常发生率,造影结果依照冠状动脉病变支数、病变血管、和狭窄程度进行分组,分析各种心律失常与冠状动脉病变情况的相关性。结果 120例中室性心律失常46例(39.0%),房性心律失常72例(61.0%)。ST段抬高79例(65.8%),ST段压低32例(26.7%),ST段无偏移9例(7.5%)。Lown3级及以上室性早搏发生率,冠状动脉多支病变(62.1%)显著高于单支病变(15.5%)(p<0.05);缓慢心率失常发生率,多支病变(55.6%)显著高于单支病变(22.2%)和双支病变(22.2%)(p<0.05);房性心律失常发生率,多支病变显著高于单支病变和双支病变(p<0.05)。频发室早发生率,左主干及前降支(71.4%)显著高于左回旋支(14.3%)和右冠状动脉(14.3%)(p<0.05);Lown3级及以上室性早搏发生率,左主干及前降支显著高于左回旋支和右冠状动脉(p<0.05)。而ST段抬高和ST段压低时,冠状动脉狭窄程度(大于90%)患者发生率最高。结论急性心肌梗死患者病程中多出现心律失常,且与冠状动脉病变情况密切相关,判断动态心电图检查下的心律失常有助于预判急性心肌梗死冠脉病变情况,为急性心肌梗死预后提供参考。
Objective To analyze the relationship between electrocardiogram (ECG) arrhythmia and coronary artery disease and to provide reference for diagnosis and treatment of acute myocardial infarction. Methods 120 patients with acute myocardial infarction in our hospital were selected as the research object. All patients underwent dynamic electrocardiogram and coronary angiography. The incidence of arrhythmia was recorded. The angiographic results were grouped according to the number of coronary lesions, the lesion vessels and the degree of stenosis. Analysis of various arrhythmias and coronary lesions related to the situation. Results 120 cases of ventricular arrhythmias in 46 cases (39.0%), atrial arrhythmia in 72 cases (61.0%). There were 79 cases (65.8%) of ST segment elevation, 32 cases (26.7%) of ST segment depression and 9 cases (7.5%) of ST segment without deviation. The prevalence of premature ventricular beats in Lown3 class and above, coronary artery multi-vessel disease (62.1%) was significantly higher than that in single vessel disease (15.5%) (p <0.05). The incidence of bradyarrhythmia and multi-vessel disease was 55.6% The incidence of atrial arrhythmia and multivessel disease were significantly higher in single vessel disease (22.2%) and double vessel disease (22.2%) than in single vessel disease and double vessel disease (p <0.05). The frequency of premature rupture of the compartment, left main and anterior descending branch (71.4%) was significantly higher than that of the left circumflex branch (14.3%) and right coronary artery (14.3%) (p <0.05) , Left main branch and anterior descending branch were significantly higher than left circumflex branch and right coronary artery (p <0.05). The incidence of coronary stenosis (more than 90%) was the highest in patients with ST-segment elevation and ST-segment depression. Conclusions Arrhythmia occurs frequently in the course of AMI and is closely related to the severity of coronary artery disease. Judging the arrhythmia of ambulatory electrocardiogram can help predict the severity of coronary artery disease in acute myocardial infarction and provide a reference for the prognosis of acute myocardial infarction.