急性下壁心肌梗死的心电图改变对右室梗死诊断价值的探讨  

The Diagnostic Value to Right Ventricular Infarction in Terms of ECG Changes in Acute Inferior Myocardial Infarction

作　　者：石湘芸[1] 吴旭辉[1] 费宇行[1] 徐洪涛[1] 朱智明[1] 黄璟 

机构地区：[1]海军总医院心内科,北京100037

出　　处：《天津医药》1998年第8期451-452,共2页Tianjin Medical Journal

摘　　要：回顾分析102例急性下壁心肌梗死(AIMI)的心电图变化对右室梗死(RVI)的诊断价值。在102例AMI中,结合临床诊断RVI占40.2％(41/102),以Ⅱ导联R/Q比值<1者,RVI的阳性率为75.5％;以Ⅱ、Ⅲ、aVF导联均呈QS形者,RVI的阳性率为93.8％,两者差异有显著性意义(P<0.01)。两组的敏感性(75.6％、73.2％)和准确性(80.4％、87.2％)差异无显著性意义(P>0.05),其特异性分别为83.6％和96.7％,差异有显著性意义(P<0.05)。两种心电图的测定方法均可作为早期诊断RVI的一个补充,其中以Ⅱ、Ⅲ、aVF导联QRS波形变化优于单一Ⅱ导R/Q比值的改变。To evaluate the diagnostic value of ECG changes of acute inferior myocardial infarction (AIMI) on right ventricular infarction( RVI), 102 cases of AIMI were analyzed in a retrospective study. 40.2 % ( 41 / 102)of AIMI patients were diagnosed as RVI according to comprehensive clinical criterion. The positive rates of RVI in group A with R/Q< 1 in lead Ⅱ and in group B with QS pattern in Ⅱ, Ⅲ, aVF leads was 75.5% and 93.8% respectively(P<0.01). There was no significant statistical difference of sensitivity (75.6%vs 73.2%) and of positive predictive value(80.4%vs 87.2%)between group A and group B,P >0.05.The specificity was 83.6% and 96.7% respectively(P<0.05). It was concluded that those two classification methods of ECG pattern can be used as a complementary criterion to early, diagnosis of RVI. The QRS changes of leads Ⅱ, Ⅲ, aVF were superior to the only changes of R/Q rate in lead Ⅱ in the early diagnosis of RVI.

关 键 词：心肌梗塞 诊断 心电图 AIMI 

分 类 号：R542.220.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学]