心电图判断急性下壁心肌梗死相关动脉的价值  

Implications of electrocardiogram in predicting the culprit artery in patients with inferior acute myocardial infarction

作　　者：杨彪[1] 郭航远[1] 彭放[1] 池菊芳[1] 朱敏[1] 许伟源[1] 

机构地区：[1]绍兴市人民医院心内科,浙江绍兴312000

出　　处：《临床心血管病杂志》2008年第7期520-522,共3页Journal of Clinical Cardiology

摘　　要：目的:探讨体表心电图改变在判断急性下壁心肌梗死相关动脉的价值。方法:根据冠状动脉造影结果将78例急性下壁心肌梗死患者分为右冠状动脉(RCA)组和左冠状动脉回旋支(LCX)组,比较2组患者的心电图改变。结果:①RCA组患者aVL导联ST段压低≥1 mm的发生率明显高于LCX组患者(92%∶24%,P<0.01);②RCA组患者aVL导联R/S比值明显低于LCX组[(2.7±0.4)∶(3.4±0.6),P<0.01];③aVL导联ST段压低≥1 mm和R/S比值≤3判断急性下壁心肌梗死相关动脉为RCA的敏感性、特异性、阳性预测值和阴性预测值分别为92%、90%、96%、77%和86%、95%、98%、70%。结论:aVL导联ST段压低和R/S比值缩小是判断急性下壁心肌梗死病变动脉为RCA的良好指标。Objective： To assess the value of electrocardiogram in predicting the culprit artery in patients with inferior acute myocardial infarction （AMI）. Method.-Seventy-eight patients with inferior AMI underwent selective coronary were divided into two groups, right coronary artery（RCA） group and left circumflex coronary artery （LCX） group, according to the infarct-related artery. 12-lead electrocardiograms were detected in two groups. Result：① The incidence of ST-segment depression ≥ 1mm in lead aVL was significantly higher in RCA group patients than that in LCX group patients（92% vs 24%, P〈0.01） ; ② R/S ratio in lead aVL was significantly lower in RCA group patients than that in LCX group patients（2.7±0.4 vs 3.4±0.6, P〈0.01）; ③ The sensitivity, specificity, positive predictive values and negative predictive values of ST-segment depression ≥1 mm or R/S ratio ≤3 for predicting RCA culprit lesion were 92 %, 90 %, 96 %, 77 % and 86 %, 95 %, 98 %, 70 % respectively. Conclusion..The present study suggests that ST-segment depression or decreased R/S ratio during inferior AMI confers a greater likelihood of RCA disease.

关 键 词：心肌梗死 心电图 ST段 冠状动脉造影 

分 类 号：R542.2[医药卫生—心血管疾病]