| Objective: Through this study,the early warning information of body surface ECG of acute coronary syndrome caused by left main disease was found,and the summary and analysis were carried out,so as to significantly improve the early diagnosis rate of left main disease by the first doctor,timely take corresponding measures,and reduce the clinical fatality rate of patients with left main disease.Methods: A total of 232 patients with acute coronary syndrome admitted to the department of cardiology of cangzhou people’s hospital from January2017 to December 2017 and confirmed by coronary angiography to be left main artery disease or equivalent lesions were collected.Conduct a retrospective analysis.Record to be included in the general clinical data of cases,through summary analysis of the onset of symptoms in patients with acute coronary syndrome characteristic of body surface electrocardiogram(ECG)changes,according to the results of the ECG is divided into "lead aVR st-elevation acuity 0.05 mv joint lead five ST segment or down"(that is,the phenomenon of "5 + 1"),the positive and negative groups again according to the sum of absolute value of ST segment displacement(ΣST),divided into group A(Σ ST≤12 mm)and group B(13 mm≤Σ ST <18 mm),group C(ΣST≥18 mm).Compared with the results of coronary angiography performed in the corresponding patients within one week after admission,the body surface ecg warning indicators of diagnostic value for left main disease were summarized.Rusults: There were 140 cases in the "5+1" positive group and 92 cases in the "5+1" negative group.A comparative analysis of the general data of the two groups showed that there was no statistically significant difference in riskfactors(age,gender,diabetes,hypertension,hyperlipidemia,and smoking)between the two groups(P > 0.05).Coronary angiography in the "5+1phenomenon" positive group showed simple left main disease,left main stem with single vessel disease,left main stem with double vessel disease,left main stem with three-vessel disease,and left main stem equivalent lesion The proportion of stenosis was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Statistical analysis of the extent of the absolute value of the ST segment displacement(ΣST),according to the degree of displacement into three groups A,B,C,of which 47 cases in group A(average ΣST = 6.42 ± 2.16 mm),105 cases in group B(average ΣST = 15.85 ± 2.63 mm),80 patients in group C(average ΣST =22.71 ± 3.06 mm).There were no significant differences in risk factors(age,gender,diabetes,hypertension,hyperlipidemia,smoking)between the three groups(P > 0.05).Coronary angiography in group C showed a significant proportion of severe left stenosis,left main stem with single vessel disease,left main stem with double vessel disease,left main stem with three-vessel disease,and left main trunk equivalent lesions.The control group was significantly higher than the A and B groups.The coronary angiography results of group B showed that the proportion of severe stenosis of left main with single vessel lesion,left main with double vessels lesion,left main with three vessels lesion,and left main with the same lesion was significantly higher than that of group A,and the difference was statistically significant.(P<0.05).Conclusion: The characteristic changes of body surface ECG with ST segment elevation of aVR leads and ST segment depression of 5 leads can be used as an important early warning information of left main disease.Meanwhile,the absolute sum of ST segment displacement(ΣST)≥18mm can highly indicate the left main lesion.Clinicians can detect and treat the left main disease early according to the characteristic changes of ECG,so as to reduce the clinical mortality. |
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