心电图aVR导联ST段变化对非ST段抬高型急性冠脉综合征患者的影响

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Abstract Objective To discuss the effect of ST segment changes in lead aVR of patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS).Methods A total of 168 patients with NSTE-ACS in the First Affiliated Hospital of Dalian Medical University from July 2019 to July 2020 were analyzed retrospectively,and divided into the non STaVR segment elevation group(65 cases),STaVR segment elevation 0.05-0.1 mV group(58 cases)and STaVR segment elevation ≥0.1 mV group(45 cases)according to the ST segment degree of improvement in lead aVR measurements at admission.The baseline data,occurrence of MACE within 6 months of three groups of patients were recorded and analyzed.Results The history of myocardial infarction,left ventricular ejection fraction(LVEF),Killip grade,number of diseased vessels and treatment regimen of the three groups were significant differences(P＜0.05).The cTnI,CK-MB,BNP and hs-CRP levels of the three groups were significant differences(P＜0.05);The cTnI,CK-MB,BNP and hs-CRP levels of STaVR segment elevation ≥0.1 mV group and STaVR segment elevation 0.05-0.1 mV group were higher than those of the non STaVR segment elevation group,the STaVR segment elevation ≥0.1 mV group were higher than the STaVR segment elevation 0.05-0.1 mV group,and the differences were statistically significant(P＜0.05).The(repeat)myocardial infarction,cardiovascular death and revascularization incidence rates of the three groups within 6 months were significant different(P＜0.05).The(repeat)myocardial infarction,cardiovascular death and revascularization incidence rates of the STaVR segment elevation ≥0.1 mV group and the STaVR segment elevation 0.05-0.1 mV group were higher than those of the non STaVR segment elevation group,the STaVR segment elevation ≥0.1 mV group were higher than the STaVR segment elevation 0.05-0.1 mV group,the differences were statistically significant(P＜0.05).The distribution of non STaVR segment elevation,STaVR segment elevation 0.05-0.1 mV and STaVR segment elevation ≥0.1 mV of NSTE-ACS patients MACE occurrence or not within 6 months were significant differences(P＜0.05).Multivariate logistic regression analysis showed that the LVEF(β=0.288,OR=1.586,95%CI=1.267-2.831),Killip classification(β=0.271, OR=1.716,95%CI=1.359-2.498),number of vessel branches(β=0.743, OR=2.247,95%CI=1.664-3.576),cTnI(β=0.553, OR=2.093,95%CI=1.537-3.498),CK-MB(β=1.105, OR=2.358,95%CI=1.239-3.869),BNP(β=0.934, OR=1.529,95%CI=0.913-2.722),hs-CRP(β=0.326, OR=1.768,95%CI=1.175-2.246)and STaVR segment elevation(β=0.179, OR=1.452,95%CI=1.123-2.051)were independent risk factors for MACE occurs within 6 months of NSTE-ACS patients(P＜0.05).Conclusion The MACE incidence of NSTE-ACS patients with electrocardiogram STaVR segment elevation ≥0.1 mV is higher,moreover STaVR segment elevation is the independent risk factors for MACE occurs within 6 months in NSTE-ACS patients,which should be paid much attention.

Key words： Electrocardiogram Lead aVR Non-ST-segment elevation acute coronary syndrome Major adverse cardiac events

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	QIN Yuansheng
	TANG Xiu'e

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QIN Yuansheng,TANG Xiu'e. Effect of ST segment changes in lead aVR of patients with non-ST- segment elevation acute coronary syndrome[J]. 中国当代医药, 2022, 29(10): 62-66转70.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I10/62

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