心电图Ⅱ Ⅲ、aVF导联病理性Q波对冠状动脉多支血管病变的判定价值  

Predictive value of pathologic Q waves in leads Ⅱ,Ⅲ and a VF for multivessel coronary artery disease

作　　者：颜昌福[1] 艾民[1] 夏福纯[1] 周双陆[1] 贺剑[1] 李翠萍[1] 

机构地区：[1]攀钢集团总医院心内科,四川攀枝花617023

出　　处：《心脏杂志》2015年第2期172-174,共3页Chinese Heart Journal

基　　金：四川省卫生厅科研课题资助(130574)

摘　　要：目的：探讨静息心电图II、III、aVF导联病理性Q波对冠状动脉多支病变的临床判定价值。方法：分析2006年3月-2014年4月收治的冠心病患者1007例,包括心肌梗死（MI）患者305例,根据心电图定位分为前壁MI组患者204例及下壁MI组患者101例,分析两组患者冠状动脉造影结果。结果：体表心电图病理性Q波评价冠状动脉多支血管病变患者的灵敏度为35.6%,特异度为83.0%,准确度为49.2%;前壁MI患者心电图病理性Q波评价冠脉多支病变的灵敏度（22.4%）高于下壁MI患者（13.2%）（P〈0.01）;下壁MI患者心电图病理性Q波评价冠脉多支病变的特异度（98.0%）高于前壁MI患者（85.1%）（P〈0.01）;在评价的准确度方面前壁（40.3%）与下壁MI患者（37.4%）无统计学差异。结论：II、III、aVF导联病理性Q波判断冠状动脉多支血管病变的灵敏度是前壁梗死高于下壁梗死,而特异度则是前壁梗死低于下壁梗死。AIM： To evaluate the clinical value of pathologic Q waves in leads II,III and a VF of ECG for predicting multivessel coronary artery disease（ CAD）. METHODS： Included in the study were 311 patients with myocardial infarction admitted to the Cardiology Department of our hospital from March 2006 to April 2014. According to electrocardiogram,patients were divided into two groups： 207 cases with anterior myocardial infarction and 104 cases with inferior wall myocardial infarction. Coronary angiography results of patients were analyzed. RESULTS： The rate of one-vessel CAD in anterior myocardial infarction patients was significantly higher than in patients with inferior wall myocardial infarction（ 43 cases,21%vs. 6 cases,6%; P〈0. 05）. The rate of two-vessel CAD in patients with anterior myocardial infarction was higher than in patients with inferior wall myocardial infarction（ 67 cases,33% vs. 26 cases,26%）but without a statistically significant difference. The rate of three-vessel coronary artery disease in patients with anterior myocardial infarction was significantly lower than in patients with inferior wall myocardial infarction（ 94 cases,46% vs. 69 cases,68%; P〈0. 05）. CONCLUSION： Pathologic Q waves in leads II,III and a VF of ECG indicate multivessel CAD.

关 键 词：心肌梗死 心电图 病理性Q波 冠状动脉造影术 

分 类 号：R541.4[医药卫生—心血管疾病]