急性前壁心肌梗死心电图ST段改变与前降支阻塞部位关系的研究  

The correlation between ST segment change and the obstruction site of descending anterior branch in acute anterior wall myocardial infarction patients

作　　者：刘淑君[1] 侯红霞[1] 

机构地区：[1]江苏省淮安市第二人民医院,223002

出　　处：《临床心电学杂志》2006年第1期38-40,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨急性前壁心肌梗死心电图的ST段改变与冠状动脉阻塞部位的关系。方法对34例急性前壁心肌梗死病人进行回顾性分析。结果34例患者中19例为前降支病变,15例为前降支合并多支血管病变,心电图STⅠ、aVL抬高,STⅡ、Ⅲ、aVF压低,STaVL>STⅠ,STV2>STaVR,STV3/Ⅱ<-2.3,均为前降支近端狭窄,STⅡ、Ⅲ、aVF、V5、V6抬高,STV5>STⅡ,STV6>STaVF,均为前降支远端狭窄。结论急性前壁心肌梗死病人进行心电图常规检查,可以预测梗死与冠状动脉阻塞部位的关系。STⅠ、aVL抬高,Ⅱ、Ⅲ、aVF压低>1mm,为前降支近端病变。Ⅱ、Ⅲ、aVF、V5、V6抬高>1mm为前降支远端病变。Objective We analyzed the correlation between ST segment change and the obstruction site of descending branch in acute anterior wall myocardial infarction patients with angiography. Method We retrospectively analyzed ECG of 34 acute anterior wall myocardial infarction patients. Results 19 of them were descending anterior branch obstruction patients, and the other 15 patients also combined with mutifocal obstructions. When the obstruction located at the proxomal end of descending anterior branch, ST elevation in Ⅰ ,avL, ST depression in Ⅱ,Ⅲ ,avF, STaVL〉ST 1, STV2〉STavR and STv3/0282〈-2.3 were found in ECG. When the obstruction located at the distal end of descending anterior branch, ST elevation in Ⅱ ,Ⅲ, avF,V5,V6, STV5〉STⅡ and STV6〉STavF were found. Conclusion ECG analysis of the acute anterior wall myocardial pateints may predicts the obstruction site of the descending anterior branch. ST elevation in Ⅰ , avL and ST depression in Ⅱ ,Ⅲ ,avF suggests the proxomal end obstruction and ST elevation〉1mm in Ⅱ , Ⅲ ,avF,V5.V6 suggests the distall end obstruction.

关 键 词：急性前壁心肌梗死 心电图 ST段改变 冠状动脉造影 

分 类 号：R542.22[医药卫生—心血管疾病] R540.41[医药卫生—内科学]