赵秋霞+赵俊昭+蔡坤燕

[摘要] 目的 探讨冠状动脉粥样硬化性心脏病（冠心病）三支血管病变与常规12导联心电图改变的相关性。方法 选择2013年6月—2015年10月84例临床诊断冠心病经冠状动脉造影确诊冠心病三支血管病變患者，结合冠状动脉造影前后常规12导联心电图进行对比分析。结果84例患者中冠脉造影16例有2支或单支血管100%闭塞，28例有1～3支血管弥漫性狭窄；84例患者心电图正常者12例（14.29%），ST-T异常者26例（30.95%），异常Q波16例（19.05%），碎裂QRS波（fQRS波）32例（38.10%），V2-V3（或V4）R波递增不良（PRWP）者有12例（14.29%）。 结论 冠心病三支血管病变患者心电图无特征性改变。

[关键词] 冠状动脉造影；三支血管病变；心电图改变

[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-0742（2017）01（c）-0182-03

Comparative Research on Coronary Disease Three Branch Vascular Lesion Electrocardiogram and Angiographic Features

ZHAO Qiu-xia， ZHAO Jun-zhao， CAI Kun-yan

Department of cardiovascular medicine， Zhengzhou Peoples Hospital， Zhengzhou， Henan Province， 450003 China

[Abstract] Objective To study the correlation between the coronary disease three branch vascular lesion and routine 12-leads electrocardiogram changes. Methods 84 cases of patients with coronary disease three branch vascular lesion diagnosed by the coronary artery angiography from June 2013 to October 2015 were selected and compared and analyzed according to the routine 12-leads electrocardiogram before and after the coronary arteriongraphy. Results In the 84 cases， there were 16 cases with 2 or 1 blood vessel closed， and in the 28 cases， 1 to 3 blood vessel was diffusely narrow， and the electrocardiogram of 84 cases was normal， accounting for 14.29%， 26 cases whose ST-T was abnormal， accounting for 30.95%， 16 cases whose Q wave was abnormal， accounting for 19.05%， 32 cases were with fQRS wave， accounting for 38.10% and 12 cases were with PRWP， accounting for 14.29%. Conclusion There was no characteristic change in patients with coronary disease three branch vascular lesion？electrocardiogram.

[Key words] Coronary arteriongraphy； Three branch vascular lesion； Electrocardiogram change

冠心病是老年人常见病、多发病，随着国民生活水平及饮食结构的改变，冠心病趋于年轻化，冠脉病变亦越来越广泛，尤其合并糖尿病的患者，三支血管多发性、弥漫性病变者更为多见。随着冠脉造影的推广，大量的临床研究揭示出单支血管病变与心电图改变的对应关系，但三支血管病变与心电图QRS波改变的对应关系，临床尚缺乏一致性认识。该文对该院2013年6月—2015年10月经冠脉造影诊断为冠心病三支病变的84例患者就血管病变与对应心电图改变的相关性进行了对比分析，现报道如下。

1 资料与方法

1.1 一般资料

选择该院临床诊断冠心病，经冠脉造影，由3名心内科介入医师共同判定，按冠状动脉病变标准：前降支 、回旋支 、右冠状动脉及其主要分支中至少有一支的管腔直径狭窄……