摘要：
目的:探讨心电图ST段不同改变与急性心肌梗死患者冠脉造影病变特点及生活质量的相关性.方法:选取选取2015年6月到2017年6月在本院接受治疗的急性心肌梗死患者208例,根据心电图 ST 段的改变情况将患者分为ST 段抬高组(124例)、ST 段压低组(64例)、ST 段无偏移组(20例),所有患者进行冠脉造影检查和常规治疗,比较治疗前三组患者的冠脉造影情况和冠脉狭窄程度,比较治疗 1个月后三组患者的生活质量评分.结果:在 ST 段抬高组中, 共检测出单支血管闭塞病变 99例,占 79.84％,两支或两支以上血管病变25例,占20.16％,其中侧支循环开放 19例,开放率为15.32％.在 ST 段压低组中,共检测出单支血管非闭塞病变6例,占 9.38％,两支或两支以上血管非闭塞病变 56例,占 87.50％,单支血管闭塞病变2例,占3.13％,其中侧支循环开放34例,开放率为53.13％.在 ST 段无偏移组中,单支血管闭塞病变 15例,占 75.00％,单支或多支血管非闭塞病变5例,占25.00％,其中侧支循环开放 7例,开放率为35.00％.ST 段抬高组、ST 段无偏移组患者的冠脉狭窄程度以重度狭窄为主,ST段压低组患者的冠脉狭窄程度以中度狭窄为主,三组患者的轻度狭窄、中度狭窄、重度狭窄整体比较存在统计学差异(P＜0.05).三组患者的疼痛评分、躯体受限评分、精神及活动评分整体比较具有统计学差异(P＜0.05),ST 段压低组的上述评分均显著高于 ST段抬高组和ST 段无偏移组(P＜0.05).结论:心电图 ST 段不同改变与急性心肌梗死患者冠脉造影病变密切相关,且 ST 段压低患者的预后通常较好.%Objective: To investigate the correlation between changes in ST segment of ECG and characteristics of coronary angiographic and quality of life in patients with acute myocardial infarction. Methods: 208 patients with acute myocardial infarction who were treated in our hospital from June 2015 to June 2017 were selected, and they were divided into ST segment elevation group (124 cases), ST segment depression group (64 cases), ST segment non deviation group (20 cases) according to the changes of in ST segment of ECG, all patients were underwent coronary angiography and routine treatment. The coronary angiography and the degree of coronary stenosis were compared between the three groups before treatment, and the quality of life scores were compared between the three groups 1 months after treatment. Results: In the ST segment elevation group, 99 cases with single vessel occlusion were detected, accounting for 79.84％, 25 cases with two or more than two vascular lesions, accounting for 20.16％, of which 19 cases were open collateral circulation, the opening rate was 15.32％. In the ST segment depression group, 6 cases with non occluded arteries were detected, accounting for 9.38％, 56 cases with two or more than two vascular non occlusive lesions, accounting for 87.50％, 2 cases with single vessel occlusion lesions, accounting for 3.13％, of which 34 cases were open collateral circulation, the opening rate was 53.13％. In the ST segment non deviation group, 15 cases with single vessel occlusion were detected, accounting for 75％, 5 cases with single or multi vessel non occlusive lesions, accounting for 25％, of which 34 cases were open collateral circulation, and the opening rate was 35.00％. The degree of coronary stenosis in ST segment elevation group and ST segment non deviation group was mainly severe stenosis, the degree of coronary stenosis in ST segment depression was mainly moderate stenosis, and overall comparison of mild stenosis, moderate stenosis, severe stenosis in patients of three groups was statistically significant (P＜0.05). Overall comparison of pain score, physical confinement score, mental and activity score of patients in three groups were statistically significant (P＜0.05), the above scores of ST segment depression group were significantly higher than those of ST segment elevation group and ST segment non deviation group (P＜0.05). Conclusion: The different changes in ST segment of ECG are closely related to the coronary angiographic lesions in patients with acute myocardial infarction, and the prognosis of patients with ST segment depression is better.
