急性下壁心肌梗塞的心电图改变对右室梗塞诊断价值的探讨  

The Diagnostic Value to Right Ventricular Infarction 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

出　　处：《海军总医院学报》1998年第1期18-21,共4页Journal of Naval General Hospital of PLA

摘　　要：本文回顾性分析102例急性下壁心肌梗塞(AIMl)的心电图变化对右室梗塞(RVI)的诊断价值.在102例AIMI的病铡中,综合临床诊断RVI 40.2%(41/102),以Ⅱ导联R/Q比值<1值,RVI的阳性率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做为早期诊断RVI的一个补充,其中以Ⅱ、Ⅲ、aVF导联QRS波形变化优于单一I导R/Q比值的改变.To evaluate the diagnostic value of ECG changes of acute inferior myocardial in-farction (AIMI) on right ventricular infarction, (RVI), 102 cases of AIMI patients were analyzedin this retrospective study. We diagnosed 40. 2K (41/102) of AIMI patients as PVI according tosynthetic clinical criterion. The positive rates of RVI in group A with R/Q<1 in lead Ⅱ and ingroup 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 sensitivit (75. 6% vs. 73. 2% ) and of positive pre-dictive value (80. 4% vs. 87. 2%) between group A and,group B, P>0. 05. The specificity was83. 6% and 96. 7% respectively (P<0. 05). We concluded that those two classification methods ofECG pattern can be use as a complementary criterion to early diagnosis of RVI. The QRS changesof leads Ⅱ、Ⅲ、aVF was superior to the only changes of R/Q rate in lead Ⅱ in the early diagnosisof RVI.

关 键 词：急性 下壁 心肌梗塞 心电图 右室梗塞 诊断 

分 类 号：R542.220.4[医药卫生—心血管疾病]