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目的通过对ACS患者选择性冠状动脉造影(CAG)结果及体表心电图表现的分析,进一步加深对ACS患者冠状动脉病变程度的认识,为临床医生及早预测病情凶险,采取干预措施提供一定的参考。方法87例行冠状动脉造影的临床诊断ACS患者为研究对象。男62例,女25例,平均年龄(59.86±11.21)岁。根据冠状动脉造影结果,血管的狭窄程度判定如下:<50%为无明显狭窄,≥50%为有意义,50%～75%为轻度狭窄,75%～90%为中度狭窄,90%～99%为重度狭窄,100%为完全闭塞。病变部位分为左主干(LM)、左前降支(LAD)、左回旋支(LCX)、右冠脉(RCA)。根据受累血管的支数分单支、双支和多支病变。结果前壁?前间壁?广泛前壁及侧壁缺血的罪犯血管为LAD;侧壁缺血的罪犯血管除LAD外,还有LCX;下壁缺血者,其罪犯血管主要为RCA,少部分为LCX,极少部分为LAD。下壁及右室同时缺血者,高度提示RCA病变。NSTMI组中以双支以上重度病变为主。LM病变存在于广泛ST段下移的UA组中。UA的ST段改变呈多样性,以ST下移和ST无变化为主;ST无变化者,以双支或多支中重度病变为多。结论ECG对ACS单支冠脉病变定位准确率较高。LM病变存在于广泛ST段下移的UA组中。NSTMI多提示多支严重病变。UA心电图ST-T改变呈多样性,以ST段下移和ST段无变化为多见。心电图正常的UA患者中,除少部分为轻度冠脉狭窄外,多为双支或多支较重病变。
Objective To further understand the degree of coronary artery lesion in patients with ACS by analyzing the results of selective coronary angiography (CAG) and surface electrocardiogram (ECG) in patients with ACS, and to provide some references for clinicians to predict their risk as early as possible and to take intervention measures. Methods A total of 87 patients undergoing coronary angiography were enrolled in this study. There were 62 males and 25 females with an average age of (59.86 ± 11.21) years. According to the results of coronary angiography, the degree of stenosis of blood vessels was determined as follows: <50% was no obvious stenosis, 50% was significant, 50% ~ 75% was mild stenosis, 75% ~ 90% was moderate stenosis, 90% ~ 99% for severe stenosis, 100% for complete occlusion. Lesions were divided into left main (LM), left anterior descending (LAD), left circumflex artery (LCX), right coronary artery (RCA). According to the number of affected vessels divided into single, double and multiple lesions. Results The anterior wall of the anterior wall extensive anterior and lateral ischemic criminals blood vessels for LAD; lateral ischemic criminals blood vessels in addition to LAD, there LCX; inferior ischemic, the culprit vessels RCA, less Some for LCX, very few for LAD. Lower wall and right ventricular ischemic were highly suggestive of RCA lesions. NSTMI group to more than double the main disease-based. LM lesions are present in the UA group with extensive ST-segment elevation. UA ST segment showed a diversity of changes to ST down and ST ST unchanged; ST no change in patients with double or multiple moderate to severe lesions. Conclusion The ECG has a higher accuracy in locating ACS coronary artery lesions. LM lesions are present in the UA group with extensive ST-segment elevation. NSTMI more tips for multiple serious disease. UA electrocardiogram ST-T changes showed a diversity of ST-segment down and ST-segment changes are more common. UA patients with normal ECG, with the exception of a small number of mild coronary stenosis, mostly double or multiple severe lesions.