急性下壁心肌梗死伴有胸前导联ST段压低的临床意义  

Clinical implication of precordial ST segment depression in patients with acute inferior myocardial infarction

作　　者：富路[1] 张师义[1] 屈昌芝[1] 

机构地区：[1]哈尔滨医科大学附属第一临床学院心内科,黑龙江哈尔滨150001

出　　处：《心脏杂志》2009年第4期547-549,共3页Chinese Heart Journal

摘　　要：目的分析急性下壁心肌梗死（acute inferior myocardial infarction，AIMI）伴有胸前导联ST段压低的冠状动脉病变特点及临床意义。方法回顾分析2006年8月～2007年8月住院的AIMI患者91例。按胸前导联ST段是否压低将患者分为4组：胸前导联ST段无压低组（n=27）；胸前导联仅V1～4ST段压低组（n=26）；胸前导联仅V5～6 ST段压低组（n=12）；广泛胸前导联卵段压低组（n=26）。结果AIMI伴有胸前导联V1～4 ST段压低与冠状动脉多支病变呈负相关，ORⅢ=0．38，无统计学意义；AIMI伴有胸前导联V1～6ST段压低与冠状动脉多支病变呈正相关，ORⅣ=5．25，P〈0．01，有显著统计学意义。胸前导联V1～6ST段压低组与其他组相比较，左室射血分数（LVEF）低，差异显著（P〈0．05）；该组前降支病变率高（73．1％），但与其他3组相比无统计学差异。结论AIMI伴有胸前导联V1～6ST段压低提示多支病变，且心功能不全发生率高。AIM： To investigate the relationship between coronary lesion characteristics and precordial ST segment depression and its clinical implication in patients with acute inferior myocardial infarction （AIMI）. METHODS ： Ninety one patients with the first AIMI were divided into four groups on the basis of admission electrocardiograms ： Group Ⅰ-patients with no precordial ST segment depression （n = 27）, Group Ⅱ-patients with ST segment depression in leads V1 to V4 （n = 26）, Group Ⅲ-patients with ST segment depression in leads V5 -V6 （n = 12） and Group Ⅳ of patients with ST segment depression in leads V1 - V6 （ n = 26）. RESULTS ： V1 - V4 ST segment depression in AIMI was negatively correlated with multivessel lesion （ ORⅢ = 0. 38, P 〉 0.05） , whereas V1 - V6 ST segment depression in AIMI was positively correlated with muhivessel lesion （ ORⅣ= 5.25, P 〈 0. 01 ） and lower left ventricular ejection fraction （P 〈 0. 01 ）. CONCLUSION： V1 - V6 ST segment depression in AIMI suggests higher incidence of muhivessel lesion and heart failure.

关 键 词：心肌梗死 急性 下壁 胸前导联ST段压低 冠状动脉多支病变 

分 类 号：R541.4[医药卫生—心血管疾病]