急性下、后壁心肌梗塞Ⅱ、Ⅲ导联ST段抬高幅度诊断右室梗塞的价值  

The Value of ST Elevation in Lead Ⅱ and Lead Ⅲ in the Diagnosis of Right Ventriular Infarction During Acute Inferior/Posterior Infarction

作　　者：杜复勇[1] 张延荣[1] 魏经汉[1] 刘明华[1] 蔡新安 邢艳丽 

机构地区：[1]河南医科大学第一附属医院心内科

出　　处：《起搏与心脏》1990年第3期120-122,共3页

摘　　要：分析急性下、后壁心肌梗塞70例患者(并束支阻滞者除外)的心电图结果显示:Ⅱ导联ST段有或无抬高,Ⅲ导联ST段抬高大于1mm,且Ⅲ导联ST段抬高幅度大于Ⅱ导联(即STⅢ/Ⅱ>1)者,在并有右室梗塞的29例中有26例(89.66％);无右室梗塞的41例中有15例(36.66％),二组间ST段抬高Ⅲ/Ⅱ>1检出率有非常显著性差异(P<0.001)。作者认为ST段抬高Ⅲ/Ⅱ>1可作为急性下、后壁心肌梗塞合并右室梗塞的诊断依据之一,其敏感度、特异度分别为89.66％、63.41％。阳性预告值为63.41％。本资料还显示:Ⅱ导联ST段无抬高,仅Ⅲ导联ST段抬高≥1mm对右室梗塞的诊断更具有特异性。ECG of 70 patients with acute inferior/posterior infarction (no bundle branch block) was studied. In 26 patients(89. 66%) with right ventricular infarction (RVI) and in 15 patients (36. 6%) without RVI the ECG showed ST elevation in lead III exceeding that of lead I (ratio III /II>1). The positive rate of ST III/II>1 was significantly different berween the patients with RVI and that without RVI (P< 0. 001). It is concluded that ST elevation in lead III exceeding that of lead II can be one of the bases for a diagnosis of RVI in ECG-diagnosed inferior/posterior infarction. The sensitivety and specificity were 89. 66% and 63. 41% respectively. The positive predictive value was 63. 41%. If ST elevation appears only in lead III (but not in lead II) a highter specificity would be expected.

关 键 词：心肌梗塞 右室梗塞 心电图 

分 类 号：R542.220.4[医药卫生—心血管疾病]