急性冠状动脉综合征患者心电图U波倒置与冠状动脉病变的相关性
The relationship between U wave inversion and coronary lesions in patients with acute coronary syndrome
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摘要: 目的:分析并评价急性冠状动脉综合征(ACS)患者心电图U波倒置与冠状动脉病变之间的相关性。方法:经冠状动脉造影诊断为ACS患者86例,根据心电图U波倒置与否分为U波倒置组和U波非倒置组;比较2组各冠状动脉病变指标差异。结果:38例患者存在U波倒置,48例患者无U波倒置。U波非倒置组不稳定型心绞痛的发生率明显高于U波倒置组(P<0.01),而ST段抬高心肌梗死的发生率低于U波倒置组(P<0.01)。U波倒置组与U波非倒置组比较,E/A比值减小,左心室射血分数值减小(P<0.01)。U波倒置组主要表现为冠状动脉中度与重度狭窄,U波非倒置组主要表现为无明显病变与轻度狭窄,2组差异有统计学意义(P<0.01)。2组冠状动脉病变表面形态差异有统计学意义(P<0.01)。U波倒置组的左主干与左前降支两支病变发生率均高于U波非倒置组(P<0.01和P<0.05),而2组的左回旋支与右冠状动脉两支的病变发生率差异无统计学意义(P>0.05)。2组在单支、双支和多支冠状动脉病变发生率差异有统计学意义(P<0.01)。U波倒置深度在冠状动脉病变支数及狭窄程度间差异均有统计学意义(P<0.01),而在冠状动脉病变表面形态间差异无统计学意义(P>0.05)。结论:心电图U波倒置情况能够有效反映出ACS患者的冠状动脉病变程度。Abstract: Objective: To analyze the relationship between U wave inversion and coronary lesions in patients with acute coronary syndrome. Methods: Eighty-six ACS patients diagnosed by coronary angiography were divided into the U wave inversion group and non-U wave inversion group according to the U wave of electrocardiogram. The index of different coronary artery lesions between the two groups were compared. Results: The U wave inversion in 38 cases and non-U wave inversion in 48 cases were identified. The incidence of UA and ST segment elevation myocardial infarction in non-U wave inversion group were significantly more and less than those in U wave inversion group, respectively(P<0.01). Compared with non-U wave inversion group, the value of E/A and LVEF in U wave inversion group decreased(P<0.01). U wave inversion group was mainly characterized by moderate and severe stenosis, no obvious lesion and mild stenosis in non-U wave inversion group were identified, and the differences of those were statistically significant(P<0.01). The difference of the surface morphology of coronary lesions between two groups was statistically significant(P<0.01). The incidence in left main(LM) and left anterior descending(LAD) in U wave inversion group were higher than those in non-U wave inversion group(P<0.01), and the differences of the incidence of left circumflex and right coronary artery(RCA) between two groups were not statistically significant(P>0.05). The differences of the incidence of the single, double and three lesions vessels between two groups were statistically significant(P<0.01). The differences of the incidence of U wave inversion depth, coronary lesion vessels and degree of stenosis between two groups were statistically significant(P<0.01), the difference of the surface morphology of coronary lesions between two groups was not statistically significant(P>0.01). Conclusions: ECG U wave inversion in patients with ACS can effectively reflect the severity of coronary lesions.
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Key words:
- coronary disease /
- acute coronary syndrome /
- electrocardiogram /
- U wave inversion
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