老年急性心肌梗死患者心电图定位与冠状动脉造影梗死相关血管的关系

Relationship between electrocardiogram localization and infarct-related blood vessels detected by coronary angiography in eld-erly patients with acute myocardial infarction

中文关键词: 老年  急性心肌梗死  梗死相关血管  心电图  冠状动脉造影

英文关键词: elderly  acute myocardial infarction  infarct-related blood vessel  electrocardiogram  coronary angiography

中文摘要:

      目的 探究老年急性心肌梗死(AMI)患者心电图(ECG)与冠状动脉造影(CAG)梗死相关血管的关系.方法 选取2021年3月—2024年3月自贡市第一人民医院收治的102例行经皮冠状动脉介入治疗的老年AMI患者作为研究对象,分析ECG、CAG检查结果,评估ECG在CAG梗死相关血管诊断中的应用价值.结果 以CAG检查为金标准,本研究中右冠状动脉(RCA)梗死患者71例,左回旋支(LCX)梗死患者31例,Ⅰ导联ST段压低、aVL导联ST段压低、Ⅰ和aVL导联ST段均压低、V5和V6导联ST段均压低诊断梗死血管为RCA的灵敏度分别为83.10％、77.46％、77.46％、56.34％,特异度分别为 70.97％、67.74％、70.97％、77.42％,准确度分别为 79.41％、74.51％、75.49％、62.75％,阳性预测值分别为 86.57％、84.62％、85.94％、85.11％,阴性预测值分别为 64.71％、56.76％、57.89％、43.64％;Ⅰ和aVL导联的ST段均不压低、V5和V6导联的ST段抬高诊断梗死血管为LCX的灵敏度分别为67.74％、74.19％,特异度分别为88.73％、57.75％,准确度分别为82.35％、62.75％,阳性预测值分别为72.41％、43.40％,阴性预测值分为86.30％、83.67％.结论 在ECG预测RCA病变的指标中,Ⅰ导联ST段压低的灵敏度最高,在预测LCX病变的指标中,Ⅰ和aVL导联ST段均未下移的特异度最高.

英文摘要:

      Objective To investigate the relationship between electrocardiogram(ECG)and infarct-related blood ves-sels detected by coronary angiography(CAG)in elderly patients with acute myocardial infarction(AMI).Methods A total of 102 elderly AMI patients who underwent percutaneous coronary intervention in Zigong First People's Hospital from March 2021 to March 2024 were selected as the research subjects.All of them underwent ECG and CAG examinations,and examina-tion results were analyzed.The application value of ECG in the diagnosis of infarct-related blood vessels detected by CAG was evaluated.Results Taking CAG examination as the gold standard,in this study,there were 71 patients with right coronary ar-tery(RCA)infarction and 31 ones with left circumflex artery(LCA)infarction.The sensitivity of diagnosing infarcted vessels as RCA based on ST segment depression in lead Ⅰ,ST segment depression in lead aVL,ST segment depression in both lead Ⅰ and aVL,and ST segment depression in both lead V5 and V6 were 83.10％,77.46％,77.46％,and 56.34％,respectively;the specificity were 70.97％,67.74％,70.97％,77.42％,respectively;the accuracy rates were 79.41％,74.51％,75.49％,62.75％,respectively;the positive predictive values were 86.57％,84.62％,85.94％,85.11％,respectively;the negative predictive values were 64.71％,56.76％,57.89％,43.64％,respectively.The sensitivities of diagnosing infarcted vessels as LCA based on non-ST-segment depression in leads Ⅰ and aVL and ST segment elevation in leads V5 and V6 were 67.74％and 74.19％,respectively;the specificity were 88.73％and 57.75％,respectively;the accuracy rates were 82.35％and 62.75％,respectively;the positive predictive values were 72.41％and 43.40％,respectively;the negative predictive values were 86.30％and 83.67％,respectively.Conclusion Among the indicators for predicting RCA lesions in ECG,the sensitivi-ty of ST segment depression in lead Ⅰ is the highest.Among the indicators for predicting LCA lesions,the specificity of ST segment depression in both lead Ⅰ and aVL is the highest.