阵发性室上性心动过速ST段压低患者冠脉造影结果分析

    The analysis of coronary angiography results in patients with ST-segment depression during paroxysmal supraventricular tachycardia episodes

      摘要
    • 摘要:
        目的  探讨阵发性室上性心动过速（PSVT）发作时ST段压低患者冠状动脉造影结果的影响因素及与ST段压低形态的关系。
        方法  选取PSVT发作时伴ST段压低，且已行腔内电生理检查及冠状动脉造影术的患者74 例，根据冠状动脉造影结果分为造影阴性组（n=47）与造影阳性组（n=27）。比较两组患者临床资料、血液生化指标、PSVT类型、10年动脉粥样硬化性心血管疾病（ASCVD）风险及ST段压低形态，分析冠状动脉造影结果的影响因素。
        结果  与冠状动脉造影阴性组相比较，造影阳性组患者年龄更大（63±10 vs. 55.2±9）岁, P<0.01，合并高血压的比例更高（48 % vs. 15 %），P<0.01，出现胸闷/胸痛症状的比例更高（96 % vs. 66 %）, P<0.05，但出现心悸症状的比例显著降低（82 % vs. 98 %）, P<0.05，而10年ASCVD风险显著增高（P<0.01）。两组患者ST段压低形态无显著差异。单因素分析中，年龄、心悸症状、胸闷/胸痛症状、高血压、10年ASCVD风险对冠状动脉造影结果有影响。多因素Logistic回归分析表明胸闷/胸痛症状（OR=11.437, 95%CI 1.315～99.488, P<0.05）、10年ASCVD风险（OR=2.570, 95%CI 1.205～5.481, P<0.05）是冠状动脉造影结果的独立影响因素。
        结论  PSVT发作时ST段压低形态对冠状动脉造影结果无显著预测价值。10年ASCVD风险越高，且伴有胸闷/胸痛症状的患者，对冠状动脉造影可能有一定预测价值。

       

      Abstract:
        AIM   To investigate the influencing factors of coronary angiography results in patients with ST-segment depression during paroxysmal supraventricular tachycardia (PSVT) episodes, and its relationship with ST-segment depression types.
        METHODS  74 patients with ST segment depression during the onset of PSVT and who had undergone intracavitary electrophysiological examination and coronary angiography were selected. According to the results of coronary angiography, they were divided into negative angiography group (n=47) and positive angiography group (n=27). The clinical data, blood biochemical indexes, PSVT type, 10-year risk of atherosclerotic cardiovascular disease (ASCVD) and ST segment depression type were compared between the two groups, and the influencing factors of coronary angiography results were analyzed.
        RESULTS  Compared with the negative group of coronary angiography, the patients in the positive group were older (63 ± 10 vs. 55.2 ± 9, P<0.01), and the proportion of hypertension was higher (48% vs. 15%, P<0.01). The incidence of chest tightness and chest pain was higher (96% vs. 66%, P<0.05), but the incidence of palpitation was significantly lower (82% vs. 98%, P<0.05), and the 10-year risk of ASCVD was significantly higher (P<0.01). There was no significant difference in ST segment depression between the two groups. In univariate analysis, age, palpitation symptoms, chest tightness/chest pain symptoms, hypertension and 10-year ASCVD risk had an impact on the results of coronary angiography. Logistic regression analysis showed that chest tightness/chest pain symptoms (OR=11.437, 95% CI 1.315～99.488, P<0.05) and 10-year ASCVD risk (OR=2.570, 95% CI 1.205～5.481, P<0.05) were independent influencing factors of coronary angiography results.
        CONCLUSION  The shape of ST segment depression during the onset of PSVT has no significant predictive value for the results of coronary angiography. The higher the risk of ASCVD in 10 years, and the patients with chest tightness/chest pain symptoms may have a certain predictive value for coronary angiography.

       

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