急性下壁心肌梗塞V_1-V_4导联ST段下移的临床意义  

CLINICAL SIGNIFICANCE OF PRECARDIAL (V_1-V_4)ELECTROCARDIOGRAPHIC S-T SEGMENT DEPRESSION ON ACUTE INFERIOR MYOCARDIAL INFARCTION

作　　者：阳旭军 刘锦萍 黄映红 付广 

机构地区：[1]湖南省长沙市第一医院,410005

出　　处：《中国现代医学杂志》1997年第11期9-11,共3页China Journal of Modern Medicine

摘　　要：目的：根据临床资料探讨急性下壁心肌梗塞（AIMI）V1－V4导联ST段下移（STD）的临床意义。方法和结果：AIMI61例，STD≥0．1mv30例（A组），＜0．lmv31例（B组）。分别比较A和B组临床因素和冠心病死亡发生率：其中肺部罗音、心功能Ⅱ～Ⅳ级及Ⅳ级、Ⅲ度房室传导阻滞、持续性低血压休克综合征及住院期内冠心病死亡率A组均显著高于B组（均P＜0．01）。而A组STD导联数≥3（∑ST≥3）的心功能≥Ⅲ级、休克综合征和住院期内死亡率显著高于∑ST≤2者（P＜0．05）；STD均值XST≥0．2mv住院死亡率也显著高于XST≥0．1（＜0．2）my，（P＜0．05）。结论：该组结果表明AIMIV1－V4导联STD≥0．1mv预示高危亚组；兼有∑SF≥3者发生高危事件危险性进一步增加；而同时有XST≥0．2mv和∑ST≥3者发生最高危心脏事件的危险性最大。The determination of the genesis of precardial (V1 - V4 ) S - T segment depression (STD) during acute inferiormyolardial infarction (AIMI) is potentially of great clinical importance. The STD in group A (30 of 61 patients)was 0.1 mV or greater in one or more Precardial leads (V1 - V4 ). The STD in the remaining 31 patients (group B)was normal. Patients in group A had a higher incidence of rales, Killip class Ⅱ - Ⅳ, third degree atrioventricularblock, persistent hypotension with shock syndrome, and in - hospital death (P < 0.01 or P < 0.005 ). The patientswith STD of three of four precardial leads had a higher incidence of Killip Ⅲ and Ⅳ (P<0.01), shock syndromeand in - hospital death (P <0.05) than patients with STD of zero to two precardial leads. In addition, patientswith both an STD average of 0. 2 mV or greater and STD of three or more precardial leads had the highest in - hosPital mortality rate. This study indicates that an STD of 0.1 mV or greater identifies a high risk subgroup of patients with AIMI, patients with STD of three or more precardial leads are at a higher risk for infarction related complications, and patients with both of these indications are at the highest risk for further detrimental cardiac events.

关 键 词：急性 心肌梗塞 心电图 ST段 

分 类 号：R542.220.4[医药卫生—心血管疾病]