不同节段回旋支急性闭塞的临床及心电图特点  

Clinical and Electrocardiographic Features of Patients with Occlusion of Different Segments of the Left Circumflex Coronary Artery

作　　者：李晓红[1] 刘胜辉[1] 西铮[1] 尹博英[1] 王龙[2] 郭继鸿[2] 王伟民[2] 

机构地区：[1]河北大学附属医院心血管内科,河北省保定市071000 [2]北京大学人民医院心脏中心

出　　处：《中国全科医学》2011年第23期2670-2672,共3页Chinese General Practice

摘　　要：目的分析不同节段回旋支（LCX）急性闭塞的临床及心电图特点。方法回顾性分析2005—2009年北京大学人民医院行急诊经皮冠状动脉介入患者中LCX单支闭塞者罪犯血管开通前的临床情况及心电图。结果 80例LCX闭塞患者中无合并右室梗死者,无低血压、晕厥死亡者。出现心律失常Ⅲ度房室传导阻滞者6例,均为近段病变。80例患者中14例STV1~V3压低及10例STI、AVL抬高者均为近段闭塞,即LCX近段病变可表现为高侧壁心肌梗死和前壁非ST段抬高性心肌梗死。远段闭塞者中均有STⅡ、Ⅲ、AVF抬高。2例钝缘支闭塞患者反复观察心电图未见异常。LCX各节段闭塞的心电图在STV7~V9抬高的发生率间差异无统计学意义（P〉0.05）。结论前壁非ST段抬高性心肌梗死可能为回旋支闭塞所致,应行急诊经皮冠状动脉介入。Objective To investigate the clinical and electrocardiographic features of patients with occlusion of different segments of the left circumflex coronary artery（LCX）.Methods Eighty patients with acute inferior myocardial infarction due to single-vessel occlusion of the left circumflex（LCX） coronary artery were enrolled.All patients underwent emergency coronary angiography.Clinical features and electrocardiogram findings before revascularization of the culprit arteries were retrospectively analyzed.Results Right ventricular infarction,syncope,hypotension and sudden death were not seen among all these patients.Artrioventricular block（grade Ⅲ） due to proximal artery occlusion was found in 6 patients.Fourteen patients were with precordial ST segment depression and 10 patients were with ST elevation in lead I AVL due to proximal artery occlusion.Patients with distal artery occlusion were all with ST elevation in lead Ⅱ,Ⅲ,AVF.Two patients with obtus marginal occlusion showed no electrocardiogram ST changes.Incidence of ST elevation in lead V7~V9 among patients with left circumflex coronary artery occlusion of different segments were not statistically different（P0.05）.Conclusion Non-ST-elevation acute coronary syndromes may be caused by left circumflex（LCX） coronary artery occlusion;emergency percutaneous coronary interventions should be performed.

关 键 词：不同节段回旋支急性闭塞 STV1~V3压低 急诊经皮冠状动脉介入 

分 类 号：R541[医药卫生—心血管疾病]