心电图“镜面”导联ST段改变对前壁心肌梗死相关血管的判定价值  

Relationship between ST-segment change of mirror lead and coronary infarct related artery in patients with anterior wall myocardial infarction

作　　者：王江洪[1] 胡晓军[1] 孙跃玲[1] 吴丹[2] 

机构地区：[1]湖北省新华医院心内科,武汉430000 [2]华中科技大学同济医学院

出　　处：《临床急诊杂志》2015年第3期172-175,共4页Journal of Clinical Emergency

摘　　要：目的：研究急性前壁心肌梗死心电图＂镜面＂导联ST段改变对梗死相关血管的判定价值。方法：分析132例首次发生急性前壁心肌梗死患者的某些心电图的特征改变,对比患者入院时的冠脉造影资料。结果：急性前壁心肌梗死心电图伴下列1项或以上者对预测梗死相关血管为左前降支近段有较高的敏感性和特异性：1有下壁导联ST↓;2伴STI/aVL↑;3STIII↓〉STII↓;4STV1〉0及STV6≤0,其中急性前壁心肌梗死心电图伴STIII↓〉STII↓时预测梗死相关血管为左前降支近段敏感性和特异性最高;如伴下列1项或以上者对预测梗死相关血管为左主干有较高的敏感性和特异性：1STII、III、avF↓伴STavR↑〉STavL↑;2STV4~V6↓伴STaVR↑〉STV1↑。结论：分析急性前壁心肌梗死心电图＂镜面＂导联ST段某些特征的改变判定急性前壁心梗梗死相关血管部位有比较好的临床应用价值。Objective：Through the analysis of some characteristic changes of the acute anterior wall myocardial Infarction（AAMI）electrocardiogram,we compared them with the outcome of coronary angiography and studied the relationship between ST-segment change of mirror lead in AAMI and coronary infarct related artery（IRA）.Method：The changes of clinical electrocardiogram and the results of coronary angiography（CAG）of 132 Patients with first AAMI were analyzed in study.Result：AAMI with the following Paragraphs,1or more having the LAD Proximal as the IRA：1AAMI with ST↓of the mirror lead,2AAMI with STI/aVL↑,3AAMI with ST〉III↓STII↓,4AAMI with STV1〉0and STV6≤0,STIII↓〉STII↓.AAMI with the following paragraphs 1or more having the LM Proximal as the IRA：1STII、III、avF ↓ and STavR ↑ STavL ↑,2STV4~V6↓and STaVR ↑〉STV1↑.Conclusion：It have a good clinical value through the analysis of some characteristic changes of the AAMI electrocardiogram that we can predict the IRA.

关 键 词：急性前壁心肌梗塞 心电图 梗死相关血管 冠状动脉造影 

分 类 号：R542.2[医药卫生—心血管疾病]