不同部位冠状动脉阻塞的心电图特征  

Characters of electrocardiogram in coronary occlusion with various location

作　　者：潘伟民[1] 孙静[1] 叶红华[1] 程典升[1] 

机构地区：[1]宁波市第一医院,315010

出　　处：《现代实用医学》2002年第3期119-121,129,共4页Modern Practical Medicine

摘　　要：目的　通过冠状动脉 (冠脉 )造影和标准心电图的对比 ,找出不同部位冠脉阻塞的心电图特征。　方法　对 84例急性心肌梗死的患者作了冠脉造影及 12导联心电图检查 ,将不同部位冠脉阻塞的造影结果与心电图作了对比。　结果　左前降支阻塞时V2 4ST段抬高的发生率最高 ,其敏感性、特异性、阳性预测值和阴性预测值分别为 81.4 %、85 .7%、80 .3%及 86 .6 %。右冠脉阻塞时aVF的ST段抬高的发生率最高 ,其敏感性、特异性、阳性预测值和阴性预测值分别为 86 .7%、96 .3%、92 .9%、97.9%。左旋支阻塞时任何导联ST段抬高发生率的敏感性和阳性预测值都 <2 5 .0 % ,特异性和阴性预测值也 <79 .0 %。　结论　心电图指标对右冠脉及左前降支阻塞的诊断优于左旋支。Objective To find characters of electrocardiongram (ECG)in coronary occlusion with various location through comparison of coronary angiongraphy and ECG. Methods Coronary angiography and ECG were compared in 84 patients of acute myocardial infarction with various location of coronary occlusion. Results ST segment elevations of V 2-4 were most freqently found in left anterior descending artery(LAD) occlusion,with sensitivity,specificity,positive predictive value and negative predictive value being 81.4%, 85.7 %,80.3% and 86.6%,respectively.So was ST segment elevation of aVF in right coronary artery (RCA) occlusion,with sensitivity,specificity, positive predictive value and negative predictive value bing 86.7%,96.3%,92.9 and 97.9%,respectively. Both sensitivety and positive predictive value of ST segment elevation of any lead in left circumflex artery (LCX) occlusion were less than 25.0%,and eithor specificity and negative predictive value was less than 79.0%. Conclusion ECG markers are superior in diagnosis of LAD and RCA occlusion to LCX occlusion.

关 键 词：心肌梗死 心电描记术 冠状动脉造影 比较 冠心病 

分 类 号：R541.404[医药卫生—心血管疾病] R542.220.4[医药卫生—内科学]