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时间:2020-04-29
《心电图在急性肺动脉栓塞和急性非 ST 段抬高型心肌梗死鉴别诊断中应用.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、中国实验诊断学2015年3月第19卷第3期—389—文章编号:1007-4287(2015)03-0389-04心电图在急性肺动脉栓塞和急性非ST段抬高型心肌梗死鉴别诊断中应用周娟(西安市第八医院心电图室,陕西西安710061)摘要:目的探讨心电图在急性肺动脉栓塞(APE)与急性非ST段抬高型心肌梗死(NSTEMI)鉴别诊断中应用价值。方法选择2008年—2013年我院收治的APE患者45例为APE组,NSTEMI患者85例为NSTEMI组,于入院6h内行标准12导联心电图检查,分析比较两组患者心电图变化的差异。结果(1)APE组V1-V3导联ST段压低、V1-V3导联T波倒置
2、发生率为51.11%、46.67%,高于NSTEMI组的20.00%、23.53%,差异有统计学意义(P<0.05),NSTEMI组V4-V6导联T波倒置并ST段压低发生率为30.59%,显著高于APE组的15.56%,两组比较差异有统计学意义(P<0.05)。(2)Logistic回归分析证实,V1-V3导联ST段压低及其T波倒置是APE的重要预测因子;V4-V6导联T波倒置并ST段压低是APE和NSTEMI的重要预测因子。(3)APE低、中、高风险患者间比较,SⅠQⅡTⅢ症差异有统计学意义(P<0.05)。结论V1-V3导联ST段压低与Ⅱ、Ⅲ、aVF及V1-V3导联T波倒置
3、需高度怀疑APE的可能,而V4-V6导联T波倒置、V4-V6导联T波倒置并ST段压低发生NSTEMI的可能性较高。关键词:心电图;急性肺动脉栓塞;急性非ST段抬高型心肌梗死;鉴别诊断中图分类号:R540.4+1文献标识码:AApplicationofelectrocardiogramindiagnosisofacutepulmonaryembolismandnonSTsegmentelevationacutemyocardialinfarctionZHOUJuan.(Electrocardiographicroom,theEighthHospitalofX'ian,Xi’an7
4、10061,China)Abstract:ObjectiveTostudytheapplicationofelectrocardiogramindiagnosisofacutepulmonaryembolism(APE)andnonSTsegmentelevationacutemyocardialinfarction(NSTEMI).MethodsClinicaldataof130casesofpatientswithAPEandNSTEMIfrom2008to2013inourhospitalwereretrospectiveanalyzed,including45cases
5、ofAPEpatients,85casesofNSTEMIpatients,analyzedandcomparerdthedifferenceofelectrocardiogrambetweentwogroups.Results①TheincidencerateofV1-V3leadSTsegmentdepressionandV1-V3TwaveinversioninAPEgroupwere51.11%,46.67%,higherthan20%,23.53%oftheNSTEMIgroup,therewassignificantdifferencebe-tweentwogrou
6、ps(P<0.05),theoccurrencerateofV4-V6TwaveinversioncombinedwithSTsegmentdepressioninNSTEMIgroupwas30.59%,significantlyhigherthan15.56%intheAPEgroup,therewassignificantdifferencebe-tweentwogroups(P<0.05);②TheLogisticregressionanalysisconfirmedthattheV1-V3leadSTsegmentdepres-sion,Twaveinversiona
7、ndV4-V6leadTwaveinversioncombinedwithSTsegmentlowpressurewasanimportantpredictorofAPE,NSTEMI;③ThedifferenceofSⅠQⅡTⅢsyndromeamongthelow,medium,highriskofAPEwasstatisticallysignificant(P<0.05).ConclusionV1-V3leadSTsegmentdepressionandII,III,aVFaswell
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