心向量图结合超声心动图对心梗罪犯血管的判断  

Value of vectorcardiogram combined with color Doppler echocardiogram in predicting culprit vessels of acute inferior wall myocardial infarction

作　　者：谷守明[1] 王兴德 陆英[3] Gu shouming;Wang xingde;Lu ying(Punan Hospital, Shanghai,200125,China;Shanghai Sixth People's Hospital,Shanghai,201306,China;Shanghai Oriental Hospital,Shanghai,200120,China)

机构地区：[1]上海市浦东新区浦南医院,200125 [2]上海市第六人民医院东院,201306 [3]上海市东方医院,200120

出　　处：《临床心电学杂志》2018年第4期270-273,共4页Journal of Clinical Electrocardiology

基　　金：浦东新区科技发展基金(项目编号:PKJ2008-Y11)

摘　　要：目的探讨心电向量图联合多普勒彩色超声心动图对急性下壁心肌梗死罪犯血管的预测价值。方法以我院86例临床诊断为急性下壁心肌梗死并行冠状动脉造影患者为研究对象,入院后均进行床旁心电向量图及多普勒彩色超声心动图检查,分析其罪犯血管,并与冠脉造影结果比较,评估其诊断效能。结果 VCG联合超声心动图检查确诊为急性心肌梗死灵敏度为73.26%,其中LCX血管18支,RCA血管45支,LCX血管左下构成比61.11%,显著高于RCA 20.0%(p<0.05),RCA血管右下构成比71.11%,显著高于LCX 11.11%(p<0.05);以额面ST向量指向右下判断罪犯血管RCA的灵敏度、特异度、准确率依次为71.11%、88.89%、76.19%,向左下判断罪犯血管LCX诊断效能依次为61.11%、80.0%、74.6%;罪犯血管LCX的额面最大振幅显著低于罪犯血管RCA,额面向量角度显著高于罪犯血管RCA(p<0.05)。结论心电向量图联合多普勒彩色超声心动图可有效诊断急性下壁心肌梗死,并根据额面ST向量指向判断罪犯血管,诊断效能较佳。Objective To investigate the value of vectorcardiogram(VCG) combined with color Doppler echocardiogram in predicting culprit vessels of acute inferior wall myocardial infarction. Methods 86 patients with acute inferior wall myocardial infarction who underwent coronary angiography in the hospital were selected as the subjects. All the patients were examined by bedside VCG and color Doppler echocardiography to analyze the culprit vessels, and the results were compared with those of coronary angiography. The diagnostic efficacy was evaluated.Results The sensitivity of VCG combined with echocardiography in the diagnosis of acute myocardial infarction was73.26%, including 18 LCX vessels and 45 RCA vessels. The constituent ratio of lower left LCX vessels was 61.11%,significantly higher than that of RCA(20.0%)(p<0.05), while the constituent ratio of lower right RCA was 71.11%,significantly higher than that of LCX(11.11%)(p<0.05). The sensitivity, specificity and accuracy of frontal plane ST vector pointing to the lower right in judging culprit vessels of RCA were 71.11%, 88.89% and 76.19%, respectively,while those of lower left in diagnosing culprit vessels of LCX were 61.11%, 80.0% and 74.6%, respectively. The frontal plane maximum amplitude of culprit vessels of LCX was significantly smaller than that of culprit vessels of RCA, and the frontal plane vector angle was significantly larger than that of culprit vessels of RCA(p<0.05).Conclusion VCG combined with color Doppler echocardiogram is effective in diagnosis of acute inferior wall myocardial infarction, and the diagnostic efficiency of frontal plane ST vector is good in determining culprit vessels.

关 键 词：心电向量图 超声心动图 急性下壁心肌梗死 罪犯血管 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]