急性下壁心梗心电图改变与冠状造影对照分析  

Comparision of the result derived from electrocardiogram and from coronary artery disease in patient with acute inferior myocardial infarction

作　　者：孙晓靖[1] 洪秀芳[1] 杨坤河[1] 张向阳[1] 田文庆[1] 黄定[1] 艾里[1] 

机构地区：[1]新疆医科大学第一附属医院心内科,830054

出　　处：《临床心电学杂志》2002年第3期142-144,共3页Journal of Clinical Electrocardiology

摘　　要：目的　探讨急性下壁心梗ECG相关冠脉病变的判断及合并右室梗死的判断。方法　选择急性期内进行了CAG的急性下壁心梗病人 5 8例 ,比较ECG与CAG结果。结果　 5 8例患者中单支病变 37例 ,其中右冠脉 (RCA)病变 2 9例 ,左旋支 (LCX)病变 8例。多支病变 2 1例中伴V4-V6ST段压低者 13例 ,单支病变 7例 (P <0 0 5 ) ;伴Ⅰ、aVL导联ST抬高LCX病变 3例 ,RCA病变无 (P <0 0 5 )。以V2 、Ⅲ、avFST位移代数和来判断 :STaVF +V2 >0RCA病变 2 5例 ,LCX病变 3例 (P <0 0 5 )。合并右心室梗死 5例中 ,以STⅢ/STⅡ >1判断 ,4例右并心室 (P <0 0 5 ) ,以STV2 ↓ /STavF↑≤ 5 0 %判断则有 3例 (P >0 0 5 )。结论　急性下壁心梗梗死相关血管以RCA病变为主 ,少部分为LCX病变。伴左胸前导联V4-V6ST压低多支病变多见 ;STavF +V2 >0多见于RCA病变 ;伴Ⅰ、aVL导联ST抬高则多见于LCX病变。以STⅢ/STⅡ >1判定急性下壁心梗并右室梗死 ,差别有统计学意义。Objective The results derived from ECG and coronary artery diseae in 58 patients with acute inferior myocardial infarction were assessed comparatively.Methods 58 patients with acute inferior myocardial infarction underwent CAG,To compare the results of ECG and CAG.Results 37 Patients with vessel disease (29 patients were presented RCA disease;8 patients were presented LCX disease);21 patients with two or three vessel disease.7 Patients with vessel disease and 13 patients with two or three vessel disease had ST depresion in chest leads V 4-V 6( P <0 05);3 patients with ST elevation in Ⅰ,aVL leads were presented LCX disease ( P <0 05).Among 5 patients with acute inferior myocardial infarction and right ventricular myocardial infarction,4 patients had ST Ⅲ/ST Ⅱ>1 indicated right ventricular myocardial infarction.

关 键 词：急性下壁心肌梗死 冠状动脉造影 诊断 心电图 

分 类 号：R542.22[医药卫生—心血管疾病] R540.41[医药卫生—内科学]