墓碑形改变的急性心肌梗死血管梗塞部位的相关性  

Pertinence Between the Tombstoning Electrocardiographic Pattern of ST-segment Change and Infarcted Artery Orientation in Acute Myocardial Infarction

作　　者：邓敏[1] 马前军[1] 宋建平[1] 

机构地区：[1]苏州大学附属第一医院心血管内科,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2005年第2期286-287,297,共3页Suzhou University Journal of Medical Science

摘　　要：目的　探讨急性心肌梗死(AMI)ST段呈墓碑形改变的血管梗塞部位的相关性。方法　收集10 4例进行了冠状动脉造影(CAG)AMI的患者,其中19例心电图(ECG)有墓碑形改变。结果　对比墓碑形(A组)与非墓碑形(B组)的CAG ,显示:墓碑形改变多见于前壁心梗(P <0 .0 0 1) ;墓碑形更多见于左前降支(LAD)近段及严重病变(P <0 .0 5及P <0 .0 1) ;墓碑形多见于多支病变(P <0 .0 5 )。结论　AMI时ST段呈墓碑形改变多与LAD近段严重及多支病变相关,预后较差。Objective The aim of this study is to address the pertinence between the tombstoning electrocardiographic pattern of ST-segment change and infracted artery orientation in acute myocardial infarction. Methods The study investigated 104 patients with AMI,who subsequently underwent angiography. In this population,19 patients had a definite tombstoning pattern on their admission ECG. Results Between tombstoning ECGs and non-tombstoning, campared CAG, the results were as follows:tombstoning ECGs were more strongly associated with anterior infarction and significantly influence the left anterior descending(LAD)artery (P<0.001);LAD occlusions were significantly more severe ,mostly proximal(P<0.05, P<0.01); tombstoning ECGs were significantly greater incidence of occlusion of multivessel coronary artery (P<0.05). Conclusions Although tombstoning ECGs correlates with the occlusion of a high-grade stenosis of the proximal LAD and severe abnormal ventricle wall motion,it is still greatly necessary to reperfuse and revascularize so as to ameliorate the prognosis.

关 键 词：急性心肌梗死 墓碑形 心电图 冠状动脉造影 多支病变 

分 类 号：R542.22[医药卫生—心血管疾病]