头胸导联右胸心电图对急性右心室心肌梗塞的诊断  

Detection of acute right ventricular myocardial infarction by head chest leads,right precordial electrocardiogram

作　　者：李益民[1,2] 胡大一[1,2] 崔吉君[1,2] 

机构地区：[1]北京军区总医院 [2]首都医学院附属红十字朝阳医院

出　　处：《中国危重病急救医学》1996年第5期273-275,共3页Chinese Critical Care Medicine

摘　　要：分析３４例正常对照组（组Ⅰ）和２４例急性左室下壁、右室梗塞组（组Ⅱ）患者ＷｉｌｓｏｎＶ３ＲＶ７Ｒ及头胸导联ＨＶ３ＲＨＶ７Ｒ右胸心电图。结果：组ⅠＶ５ＲＶ７Ｒ呈ＱＳ型者＞５０％，而ＨＶ３ＲＨＶ７Ｒ呈Ｒ或ｒＳ，均无ＳＴ段抬高；组Ⅱ两种心电图Ｑ波出现率相仿。比较组Ⅰ与组Ⅱ间病理Ｑ波出现率有显著性差异（Ｐ＜０．０１），在Ｗｉｌｓｏｎ导联仅见于Ｖ３Ｒ和Ｖ４Ｒ，在头胸导联则见于全部右胸导联。２４例右室梗塞患者头胸导联ＨＶ３ＲＨＶ７ＲＳＴ段抬高均＞０．１０ｍＶ，振幅高于同时间Ｗｉｌｓｏｎ导联０．０５～０．１５ｍＶ，持续时间＞７２小时，伴Ｔ波衍变。作者认为。Thirty four mormal controls(group Ⅰ)and 24 patients with left ventricular inferior myocardial infarction and right ventricular myocardial infaretion (group Ⅱ) were studied by using right precordial ECG of Wilson lead V 3R V 7R and head chest (HC) lead HV 3R HV 7R .In group I,more than 50% were found to have QS wave in V 5R V 7R ,and R or rS shaped waves were seen in all leads HV 3R HV 7R .No one had ST segment elevation.In group Ⅱ,the frequency of Q wave appearance was similar in the two types of ECG.There was a significant difference between group Ⅰ and Ⅱ in Q wave in V 3R and V 4R only,in Q wave in HV 3R HV 7R ( P <0 01).STsegments of HC lead in 24 cases were all elevated by>0 1mV in HV 3R HV 7R of HC (the amplitude being 0 05～0 15mV higher than Wilson lead at the same time and lasting more than 72 hours) and T wave had sequential changes.These findings were helpful for the diagnosis of right ventricular infarction.

关 键 词：心肌梗塞 右胸 心电图 ST段抬高 诊断 

分 类 号：R542.220.4[医药卫生—心血管疾病]