本文選題：冠心病 + CAG�。� 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:在冠心病介入診療過程中,通過對體表心電圖各波形的動態(tài)監(jiān)測,對比分析OCT與冠脈造影這兩種成像技術(shù)對心電圖變化的影響。方法:選取2015-09至2017-01就診于我院的冠狀動脈硬化患者共134例,隨機(jī)分為兩組,一組為CAG組(n=98),即在CAG成像技術(shù)指導(dǎo)下進(jìn)行介入診療,另一組為OCT組(n=36),即在CAG成像技術(shù)指導(dǎo)下進(jìn)行介入診療并行OCT檢查。在介入診療過程中,通過對體表心電圖的動態(tài)監(jiān)測,以QRS波群(R波振幅和QRS間期)、ST-T的改變?yōu)楸O(jiān)測指標(biāo)進(jìn)行統(tǒng)計學(xué)分析,將各組間的數(shù)據(jù)采用SPSS17.0統(tǒng)計軟件進(jìn)行差異性分析,以P0.05為差異有統(tǒng)計學(xué)意義,對比分析OCT和CAG在CHD介入診療過程中對心電圖的影響。結(jié)果:1基礎(chǔ)資料對比:分別對兩組患者入院資料進(jìn)行統(tǒng)計,包括性別、年齡、體重、高血壓、糖尿病、高脂血癥,結(jié)果P值均0.05,無統(tǒng)計學(xué)差異。2 CAG組在注射造影劑后,出現(xiàn)R波振幅降低或升高的32例,QRS間期增寬的25例,ST段壓低或降低、抬高或升高的共72例,T波振幅降低或倒置加深的68例,此外,有18例發(fā)生緩慢性心律失常,表現(xiàn)為竇性心動過緩,5例發(fā)生快速性心律失常,表現(xiàn)為室性心動過速。OCT組在注射造影劑后,出現(xiàn)R波振幅降低或升高的11例,QRS間期增寬的9例,ST段壓低或降低、抬高或升高的共26例,T波振幅降低或倒置加深的24例,有3例發(fā)生緩慢性心律失常,表現(xiàn)為竇性心動過緩,1例發(fā)生快速性心律失常,表現(xiàn)為室性心動過速。組間對比ECG的變化率:(1)R波振幅變化率,CAG組和OCT組32.7%vs30.6%,P=0.818,無統(tǒng)計學(xué)差異;(2)QRS間期變化率,CAG組和OCT組25.5%vs25%,P=0.952,無統(tǒng)計學(xué)差異;(3)ST段變化率,CAG組和OCT組73.5%vs72.2%,P=0.885,無統(tǒng)計學(xué)差異;(4)T波振幅變化率,CAG組和OCT組69.4%vs66.7%,P=0.763,無統(tǒng)計學(xué)差異;(5)心率減慢,CAG組和OCT組18.4%vs8.3%,P=0.157,無統(tǒng)計學(xué)差異;(6)室速,CAG組和OCT組5.1%vs2.8%,P=0.564,無統(tǒng)計學(xué)差異。結(jié)論:在CHD介入診療過程中,盡管OCT檢查需要注入更多的造影劑并且推注速度更快,但是OCT和CAG一樣會出現(xiàn)QRS波群變化、ST段壓低(或降低)或者抬高(或升高)、T波振幅降低或倒置加深、緩慢性或快速性心律失常,它們的變化率無顯著差異,所以,OCT檢查與CAG對心電圖的影響無差異。
[Abstract]:Objective: in the process of interventional diagnosis and treatment of coronary heart disease, through dynamic monitoring of the various waveforms of the body surface electrocardiogram, the effects of the two imaging techniques of OCT and coronary angiography on the changes of electrocardiogram were compared and analyzed. Methods: 134 cases of coronary arteriosclerosis in our hospital were selected from 2015-09 to 2017-01, and were randomly divided into two groups, one group of CAG (n=98), or C Under the guidance of AG imaging technology, the other group is OCT group (n=36), that is, intervention diagnosis and treatment of OCT under the guidance of CAG imaging technology. In the process of interventional diagnosis and treatment, the dynamic monitoring of the body surface electrocardiogram, QRS wave group (R wave amplitude and QRS interval), ST-T change as the monitoring index, the statistical analysis is carried out between each group. The data were analyzed with SPSS17.0 statistical software, and the difference between P0.05 and OCT was statistically significant. The effects of OCT and CAG on the electrocardiogram were compared and analyzed. Results: 1 basic data were compared: the data of admission to two groups of patients were statistically analyzed, including sex, age, weight, hypertension, diabetes, hyperlipidemia, and results. The value of P was 0.05. There was no statistical difference in 32 cases of R wave amplitude reduction or elevation after injection of contrast agent in group.2 CAG, 25 cases of QRS interval widening, 72 cases of lower or lower ST segment, elevation or elevation, 68 cases of T wave amplitude decreasing or inversion deepening, and 18 cases with slow chronic arrhythmia, manifested as sinus bradycardia, 5 cases developed fast. Tachyarrhythmia, 11 cases of R wave amplitude decrease or increase after injection of contrast agent in.OCT group, 9 cases of QRS interval widening, 26 cases of ST segment depression or depression, 26 cases of elevation or elevation, 24 cases of T wave amplitude decreasing or inversion deepening, 3 cases with slow arrhythmia, sinus bradycardia, 1 case Rapid arrhythmia, showing ventricular tachycardia. The rate of change of ECG between groups: (1) R wave amplitude change rate, CAG group and OCT group 32.7%vs30.6%, P=0.818, no statistical difference; (2) QRS interval change rate, CAG group and OCT group 25.5%vs25%, P=0.952, no statistical difference; (3) ST segment change rate, no statistics, statistics, statistics, no statistics (4) T wave amplitude change rate, CAG group and OCT group 69.4%vs66.7%, P=0.763, no statistical difference; (5) heart rate slowed, CAG group and OCT group 18.4%vs8.3%, P=0.157, no statistical difference; (6) ventricular tachycardia, CAG group and OCT group 5.1%vs2.8%, no statistical difference. And the speed of pushing is faster, but OCT and CAG will appear QRS wave group changes, ST segment depression (or decrease) or elevation (or elevation), T wave amplitude decrease or inversion deepen, slow or rapid arrhythmia, their change rate has no significant difference, so OCT examination and CAG have no difference on electrocardiogram.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4

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