急性前壁心肌梗死时下壁导联ST段压低的临床意义  

Implications of inferior ST segment depression during anterior acute myocardial infarction

作　　者：曹艳杰[1] 李兰荪[1] 陈士良[1] 贾国良[1] 程何祥[1] 

机构地区：[1]第四军医大学西京医院心内科,西安710032

出　　处：《临床心血管病杂志》1999年第2期51-53,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨急性前壁心肌梗死合并下壁导联 ST段压低的临床意义。方法 :回顾性分析2 2例首发急性前壁心肌梗死患者的心电图、冠状动脉及左室造影资料。结果 :急性前壁心肌梗死时下壁导联 ( 、 、a VF) ST段下移≥ 0 .0 5 m V组与 <0 .0 5 m V组的 、a VL导联 ST80 值有显著性差异 ( P <0 .0 5 ) ;两组的左前降支 6段 ( LAD6 )或 LAD始部病变的发生率也有显著性差异 ( P <0 .0 5 ) ;下壁导联 ST段压低≥ 0 .0 5 m V对 L AD6 或 LAD始部病变预测价值的敏感性及特异性分别是 : 导联 5 9%、5 0 % ; 导联 83%、70 % ;a VF导联 83%、70 %。结论 :急性前壁心肌梗死时下壁导联ST段压低预示 LAD6 或 L AD始部病变是高前侧壁发生透壁性心肌缺血的“镜像”反应 ,表现为 、a VL导联 ST段抬高 ;它与右冠状动脉、左旋支、多支病变以及胸前导联Objective:To study the clinical significance of inferior ST segment depression in patients with anterior acute myocardial infarction.Method:The correlation of electrocardiography and coronary angiography in 22 patients with first time anterior acute myocardial infarction was investigated retrospectively.Result:The value of ST 80 in Ⅰ、aVL leads was markedly greater in the group of inferior leads(Ⅲ、aVF) ST depression ≥ 0.05 mV than in the group of < 0.05 mV.There was also a significant incidence of lesion in the origion of LAD or LAD 6.The sensitivities and specificities of inferior ST segment depression ≥ 0.05 mV for a lesion in the origin of LAD or LAD 6 band were:lead Ⅱ:59%,50%,lead Ⅲ:83%,70%,lead aVF:83%,70%.Conclusion:Inferior ST segment depression during anterior AMI predicts a culprit lesion in the origin of left anterior descending (LAD) or LAD 6 band.It mirrors the transmural ischemia in the high anterolateral region,shown by ST segment elevation in leads Ⅰ and aVL.No relationship was found between the inferior ST segment depression and the occurrence of right coronary or left circumflex artery narrowing,or multiple vessel disease,or magnitude of ST segment elevation in anterior leads.

关 键 词：急性 前壁 下壁导联ST段 心肌梗塞 

分 类 号：R542.22[医药卫生—心血管疾病]