急性下壁心肌梗死伴aVR导联ST段压低的临床意义  

Clinical significance of acute inferior myocardial infarction with ST segment depression in lead aVR

作　　者：王松鹤[1] 陶长生[2] 

机构地区：[1]苏北人民医院心功能科,江苏扬州225001 [2]扬州大学医学院,江苏扬州225001

出　　处：《临床荟萃》2005年第23期1336-1337,共2页Clinical Focus

摘　　要：目的探讨急性下壁心肌梗死伴aVR导联ST段压低的临床意义。方法对140例确诊急性下壁心肌梗死患者,依其心电图aVR导联ST段压低与否分为Ⅰ、Ⅱ两组,比较两组间的心肌型肌酸激酮同功酶(CK-MB)峰值,超声心动图,Holter,冠状动脉造影及各种临床并发症等结果。结果Ⅰ组患者与Ⅱ组患者比较,CK-MB峰值更高(160.21±93.42)U/L vs(124.68±62.95)U/L(P<0.01),左室射血分数减低更明显(54.78±9.22)%vs(59.50±7.14)%(P<0.05),并发症也更为多见。冠状动脉造影显示,在右冠状动脉阻塞的基础上更易合并左前降支或多支病变,各种临床并发症亦明显增高。结论急性下壁心肌梗死伴aVR导联ST段压低者梗死面积大,预后不良。Objective To investigate the clinical significance of acute inferior myocardial infarction with ST segment depression in lead aVR. Methods One hundred and forty patients with acute inferior myocardial infarction were divided into two groups on the basis of ST segment depression in lead aVR： group I with ST segment depression and gorup Ⅱ with no ST segment depression. Creatine kinase-MB（CK-MB） peak, echocardiography, Holter,coronary angiography（CAG） and clinical complications were compared between two groups. Results The patients in group I had higher CK-MB peak than the patients in group 11 （160.21±93.42） U/L vs （124.68±62.95） U/L（ P〈0.01）, lower left ventricular ejection fraction （54.78± 9.22） %vs （59.50±7.14）% （ P〈0.05） and also more clinical complications. According to CAG, the patients with the left anterior descendlng（LAD） artery disease or multivessel coronary disease had more complications significantly in group Ⅰ. Conclusion In the patients with acute inferior myocardial infarction,the presence of ST segment depression in lead aVR was associated with a larger infarct size and ominous progrosis.

关 键 词：心肌梗塞 心电描记术 心室功能 左 预后 

分 类 号：R540.4[医药卫生—心血管疾病] R543.3[医药卫生—内科学]