急性心肌梗死心电图“镜面”导联ST段改变与冠脉高危犯罪血管部位临床分析  

The Relationship between ST-segment Changes of Mirror Lead in AMI and Coronary High-risk Crime Vascular Site

作　　者：王江洪[1] 徐力辛[1] 黄伟剑[1] 

机构地区：[1]温州医学院附属第一医院心内科,浙江温州325000

出　　处：《心脑血管病防治》2011年第2期99-101,I0001,I0002,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：自1945年Wolferth首次报告急性ST段抬高型心肌梗死（STEMI）时心电图常出现＂镜面＂导联ST段压低,并往往利用这一心电现象判断犯罪血管位置、分析ECG镜段导联区是否存在缺血、估价患者的心功能状态和临床预后等,随着冠脉造影和介入治疗的发展,认识进一步深入。本文对急诊经皮冠状动脉介入治疗（PCI）手术之前,利用术前心电图（ECG）＂镜面＂导联ST段压低判断冠脉高危犯罪血管部位（左主干、Objective To analyze the relationship between ST-segment changes of mirror lead in AMI and coronary high-risk crime vascular site.Methods The clinical data,electrocardiogram changes and the results of coronary angiography of 130 patients with first AMI who implemented the emergency percutaneous coronary intervention were analyzed.Results Acute anterior myocardial infarction（AAMI） with the following 1 or more by the emergency percutaneous coronary angiography showed that the crime vascular was almost located in left anterior descending section： ① inferior wall lead ST-segment down;② with I/aVL lead ST-segment elevation;③ inferior wall lead ST-segment down and STIIISTII;④STV10 and STV6≤0,and having statistically significant meaning（P0.01）. Wether The AAMI accompanied with inferior wall lead ST-segment down was not related with coronary multivessel disease,and it had no statistical significance（P=0.67）;acute inferior myocardial infarction（AIMI） with the following 1 or more by the emergency percutaneous coronary angiography showed that the crime vascular was located near right coronary section： ①Inferior wall lead ST-segment elevation and STIIISTII;②STV1≥0 but STV20;③STV3↓/STIII↑0.5,and having statistically significant meaning（P0.01）.The AAMI with STV4V6 down was coronary multivessel disease and had statistically significant meaning（P0.01）.Conclusions The ST-segment changes of mirror lead in AMI could halp to indicate the location of coronary high-risk crime vascular.

关 键 词：导联ST段压低 犯罪血管 冠脉造影 心电图 急性心肌梗死 ST段改变 经皮冠状动脉介入治疗 临床分析 

分 类 号：R542.22[医药卫生—心血管疾病] R540.41[医药卫生—内科学]