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心电图对急性下壁心肌梗死梗死相关血管判定价值的临床研究 |
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【关键词】 心肌梗塞;冠状动脉硬化;心电描记术 [摘要] 目的 评价心电图对急性下壁心肌梗死(IAMI)患者梗死相关血管判断的临床意义。方法 选择2002年1月~2005年12月IAMI患者150例,对其心电图及冠状动脉造影资料进行回顾性分析。结果 150例中,右冠状动脉(RCA)为梗死相关血管(IRA)者115例(76.7%),左回旋支(LCX)为35例(23.3%),STⅢ/STⅡ抬高比值>1、STV4R抬高≥0.5 mm、STaVL>STⅠ压低提示RCA为IRA;而STⅢ/STⅡ抬高比值<1、STⅠ抬高提示LCX为IRA。结论 心电图中STⅢ/STⅡ抬高比值、STaVL、STⅠ及STV4R变化可作为IAMI患者梗死相关血管的临床判断指标。 [关键词] 心肌梗塞;冠状动脉硬化;心电描记术 Diagnostic value of electrocardiography in vessel responsible for inferior wall acute myocardial infarction [Abstract] Objective To evaluate the clinical significance of electrocardiography(ECG) criteria for the identification of the myocardial infarct-related artery (IRA) in inferior wall acute myocardial infarction(IAMI).Methods We retrospectively analyzed 150 patients with IAMI hospitalized between January 2002 to December 2005.Results There were 115(76.7%) patients whose IRA were right coronary artery (RCA) and 35(23.3%) patients whose IRA were left circumflex artery (LCX) among the 150 patients.ST-segment elevation in lead Ⅲ exceeding that in leadⅡ,ST-segment elevation≥0.5 mm in lead V4R,ST-segment depression in lead aVL exceeding that in leadⅠindicated that IRA were RCA;elevation of ST-segment Ⅲ<Ⅱ or ST-segment elevation in lead Ⅰ,implied that IRA were LCX.Conclusion ECG criteria such as the ratio of ST-segment elevation Ⅲ/Ⅱ,ST-segment depression in lead aVL and Ⅰ,ST-segment elevation in lead V4R and Ⅰcan be used for identifying IRA in patients with IAMI. [Key words] myocardial infarction;coronary arteriosclerosis;electrocardiography 急性下壁心肌梗死(IAMI)多由右冠状动脉(RCA)病变引起,少数为左回旋支(LCX)病变所致[1],心电图共同表现为STⅡ、Ⅲ、aVF抬高,但两者预后不同,由RCA近端闭塞形成IAMI时,约半数并发恶性心律失常和血流动力学异常,而LCX闭塞引起的IAMI者预后相对较好[2]。故判断IAMI患者的梗死相关血管(IRA)对评估预后及确定下一步治疗有重要的临床意义。本文回顾性分析150例IAMI患者心电图特征及冠状动脉造影结果,旨在评价心电图对预测IAMI冠脉病变的临床意义。  [1] [2] [3] 下一页 上一个医学论文: 血小板去除术联合药物治疗原发性血小板增多症22例临床分析 下一个医学论文: 妇科手术致输尿管损伤11例临床分析
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