II导联的R/S比值以及急性冠脉综合征中红细胞分布宽度的预后意义。

R/S ratio in lead II, and the prognostic significance of red cell distribution width in acute coronary syndrome.

作者信息

Coşkun Abuzer, Eren Sevki Hakan

机构信息

Department of Emergency, Sivas Numune Hospital, Sivas 58040, Turkey.

Department of Emergency Medicine, Gaziantep University School of Medicine, Gaziantep 27310, Turkey.

出版信息

World J Clin Cases. 2019 Aug 26;7(16):2217-2226. doi: 10.12998/wjcc.v7.i16.2217.

DOI:10.12998/wjcc.v7.i16.2217

PMID:31531316

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6718784/

Abstract

BACKGROUND

In spite of developing medical technologies to discover the etiopathogenesis of diseases and developments in the treatment of coronary artery disease, acute coronary syndromes (ACS) continue to be the main cause of mortality and morbidity worldwide. New cardiac biomarkers and techniques are needed to help provide rapid diagnosis in order to evaluate risk in coronary artery patients.

AIM

To evaluate the effects of R to S ratio (RSR) in the electrocardiograph of patients with ACS, from the point of the arising complication after myocardial infarction (MI), to three-vessel disease (TVD) and mortality.

METHODS

The data of 1,296 patients with ACS, who presented to the emergency department of our hospital with chest pain between January 2014 and December 2018 and were admitted to the cardiology clinic, were retrospectively included in this cross-sectional cohort study. Patients with an RSR value less than I were assigned to group I, while those with an RSR value greater than I were assigned to group II.

RESULTS

In our study, 466 (35.9%) of the 1,296 patients, 357 (38.3%) in group 1 and 109 (29.9%) in group 2, were female, with a mean age of 61.56 ± 9.42. ST-elevation MI 573 (44.2%), unstable angina (UA) 502 (38.7%) and non ST-elevation MI 220 (17%) were more prevalent in group I. Acute anterior MI 263 (20.3) in group I, and acute inferior MI 184 (14.2) in group II was higher. Ischemic heart failure was the most common complication. In group II, the red cell distribution width (RDW) was 15.42 ± 1.82, the gensini score was 48.39 ± 36.44, the left ventricular ejection fraction was 41.17 ± 10.41, the TVD was 111 (8.5), and the mortality rate was 72 (5.6), which was significantly higher than group I RDW; in MI with ST and non-ST-elevation, in TVD, mortality and complications were high and low in UA. In single and multivariate regression analyses, the variables were associated with ACS risk.

CONCLUSION

RSR levels may be an auxiliary predictive value in ACS in terms of complications developing after MI, TVD, and mortality.

摘要

背景

尽管医学技术不断发展以揭示疾病的病因发病机制，且冠状动脉疾病的治疗也有所进展，但急性冠状动脉综合征（ACS）仍是全球范围内死亡和发病的主要原因。需要新的心脏生物标志物和技术来帮助快速诊断，以便评估冠状动脉疾病患者的风险。

目的

从心肌梗死（MI）后出现的并发症、三支血管病变（TVD）和死亡率的角度，评估ACS患者心电图中R波与S波比值（RSR）的影响。

方法

回顾性纳入2014年1月至2018年12月期间因胸痛到我院急诊科就诊并入住心脏病科门诊的1296例ACS患者的数据。RSR值小于1的患者被分配到第一组，而RSR值大于1的患者被分配到第二组。

结果

在我们的研究中，1296例患者中有466例（35.9%）为女性，第一组357例（38.3%），第二组109例（29.9%），平均年龄为61.56±9.42岁。第一组中ST段抬高型心肌梗死573例（44.2%）、不稳定型心绞痛（UA）502例（38.7%）和非ST段抬高型心肌梗死220例（17%）更为常见。第一组急性前壁心肌梗死263例（20.3%），第二组急性下壁心肌梗死184例（14.2%）更高。缺血性心力衰竭是最常见的并发症。第二组中，红细胞分布宽度（RDW）为15.42±1.82，Gensini评分48.39±36.44，左心室射血分数41.17±10.41，TVD为111例（8.5%），死亡率为72例（5.6%），均显著高于第一组的RDW；在ST段和非ST段抬高型心肌梗死中，TVD、死亡率和并发症在UA中高低不同。在单因素和多因素回归分析中，这些变量与ACS风险相关。