标准12导联与后背导联心电图对急性正后壁心肌梗塞诊断价值的评估  

EVALUATION OF THE DIAGNOSIS OF POSTERIOR ACUTE MYOCARDIAL INFARCTION BY STANDARD 12-LEAD AND POSTERIOR LEADS ELECTROCARDIOGRAM

作　　者：王孝惠[1] 郭新凤 关雨章[1] 崔熙明[1] 张金谷[1] 王铁[1] 郑柏洁[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院内科

出　　处：《中国循环杂志》1995年第2期79-82,共4页Chinese Circulation Journal

摘　　要：为评估心电图标准１２导联与后背导联（背导）对急性正后壁心肌梗塞（ＰＡＭＩ）的诊断价值，对经（９９ｍ）Ｔｃ心肌断层显像确诊的４１例ＰＡＭＩ１５导联心电图演变与７０例正常对照进行研究。结果表明，标准１２导联中以演进后的Ｒｖ２≥０．０４ｓ的预测准确度最高（８８％）；ＳＴ段压低有助于早期诊断；Ｑａ（ＶＦ）≥０．０３ｓ时应注意有无ＰＡＭＩ并存。背导中演进后的Ｑｖ８≥０．０３ｓ的预测准确度为全部指标之冠（９６％）；ＳＴ段抬高是ＰＡＭＩ早期诊断的最佳指标；Ｔ波倒置较胸导Ｔ波直立有意义，亦为具有重要价值的指标。总的说来，背导的诊断价值高于标准１２导联。To assess the diagnostic value of standard 12 leads and posterior leads electrocardiogram(ECG) for posterior acute myocardial infarction(PAMI),15-lead ECG changes of 41 patients with PAMI confirmed by (99m)Tc myocardial tomography and 70 normal controls were studied.The results showed that of the standard 12 leads,the predictive accuracy of Rv2≥0.04 s after evolution was higbest(88%);ST-segment depression was helpful for early diagnosis;coexistent PAMI should be excluded in cases with Qavf≥0.03 s,of the posterior leads Qv8≥0.03 s after evolution provided the best overall predictive accuracy(96%);ST-segment elevation was the best early ECG predictor of PAMI;inverted T wave which was also a valuable sign of PAMI had higher significance than the precordial upright T wave.As a whole,diagnostic value of the posterior leads is higher than standard 12 leads for the diagnosis of PAMI.

关 键 词：心肌梗塞 心电图 后背导联 

分 类 号：R542.220.4[医药卫生—心血管疾病]