急性下段心肌梗死心前ST段抑制量与左前降支狭窄程度的相关性研究

K. Karo, A. P. Ketaren, R. Hasan, H. Hasan, Zulfikri Mukhtar, A. C. Lubis
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引用次数: 1

摘要

背景:有很多研究证实下段STEMI的心前ST段抑制显示LAD病变,但也有很多研究未证实。虽然LAD疾病不是下段STEMI患者心前ST段抑制的主要原因,但有许多下段STEMI患者存在高级别LAD疾病。心前ST段降积是心电图诊断的标准之一。本研究的目的在于了解下段STEMI合并心前ST段抑郁患者伴LAD病变的心前ST段抑郁总量与LAD病变严重程度之间是否存在相关性。方法:对2013年12月至2017年6月在哈吉亚当马利克综合医院住院的60例心前ST段抑郁发作时间小于24小时的下段STEMI患者进行分析。根据心前ST段抑制的总和将患者分为4组。双因素分析LAD病变心前ST段下降之和与LAD严重程度的相关性,p值< 0.05有统计学意义。结果:双因素分析显示心前ST段下降与LAD病变有较强的相关性(p=0.01)。心前ST段压低的总和也与LAD的严重程度相关(p=0.01)。与LAD近端病变位置和病变复杂程度也有相关性,但无统计学意义(p=0.233和p=0.102)。经ROC曲线分析,心前ST段凹陷之和与LAD病变的切点≥5.15 mm,敏感性为70%,特异性为76.2%(AUC = 0.752,95% CI = 0.620 ~ 0.883 p< 0.001)。结论:心前ST段凹陷之和与高级别LAD病变有很强的相关性。心前ST段压低之和越大,LAD高度病变的可能性越大(p=0.01)。
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Corelation Between Sum of Precordial ST Depression in Acute Inferior Myocardial Infarction with Stenosis Severity of Left Anterior Descending Artery
Background : There were many studies proved that precordial ST depression in Inferior STEMI show LAD disease from angiografi, but there were also many who unproved . Altought LAD disease was not the main cause of precordial ST depression in Inferior STEMI, but there were many patients with Inferior STEMI who had high grade LAD disease. Sum of precordial ST depression is one of ECG criteria that can help us to prove it . The aim of this study in to know if there is corelation between sum of precordial ST depression with LAD disease and the severity of LAD disease in Inferior STEMI patients with precordial ST depression . Methods : We analized 60 patients inferior STEMI with precordial ST depression onset less than 24 hours that hospitalized in Haji Adam Malik General Hospital since December 2013-June 2017. Patients were divided in to 4 groups based on sum of precordial ST depression. Bivariate analysis were made to see the corelation between sum of precordial ST depression with LAD disease and severity of LAD, p value < 0.05 is statistically significant.  Result : Bivariate analysis show that there is strong corelation between sum of precordial ST depression with LAD disease (p=0.01). Sum of precordial ST depression also corelate with severity of LAD (p=0.01). There are also corelation with location of the lesion in proximal LAD and the complexity of the lesion but not statistically significant (p=0.233 and p=0.102). Analysis ROC curve  sum of precordial ST depression to LAD disease give the cut off ≥5.15 mm with sensitivity 70% and spesificity 76.2%(AUC 0,752 ,95% CI: 0,620 – 0,883 p<0,001) Conclusion : There is strong corelation between sum of precordial ST depression with high grade LAD disease. The more the sum of precordial ST depression the more posibility high degree LAD disease ( p=0.01).
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