18导联心电图诊断急性正后壁心肌梗死的价值  

Value of 18-lead electrocardiogram in the diagnosis of acute posterior myocardial infarction

作　　者：孙向华 姚春霞 李永利 SUN Xianghua;YAO Chunxia;LI Yongli(Heart Function Examination Room,Baoji High-tech People′s Hospital,Baoji,Shaanxi,721006)

机构地区：[1]陕西省宝鸡高新人民医院心功能室,陕西宝鸡721006

出　　处：《实用临床医药杂志》2020年第6期40-43,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨18导联心电图(18导ECG)诊断急性正后壁心肌梗死的价值。方法选取急性心肌梗死患者70例,均行常规心电图和18导ECG检查并比较诊断价值。结果综合实验室与影像学检查结果确诊28例急性正后壁心肌梗死,42例其他类型心肌梗死。18导ECG对急性正后壁心肌梗死的检出率为92.86%(26/28),其他类型心肌梗死检出率为95.24%(40/42),常规心电图对急性正后壁心肌梗死和其他类型心肌梗死的检出率分别为67.86%(19/28)和71.43%(30/42),差异有统计学意义(P<0.05)。18导ECG对急性正后壁心肌梗死的诊断敏感性、特异性和准确性高于常规心电图,漏诊率和误诊率低于常规心电图,差异有统计学意义(P<0.05)。与其他类型急性心肌梗死患者比较,急性正后壁心肌梗死患者V1~V3 ST段轻度下降、RV1轻度升高、V7~V9 ST段轻度抬高比例较高,差异有统计学意义(P<0.05)。结论18导ECG可用于急性正后壁心肌梗死诊断,可与患者临床症状和心肌酶谱检测结果相结合,减少误诊、漏诊,提高疾病诊断率。Objective To explore the value of 18-lead electrocardiogram(18-lead ECG)in the diagnosis of acute posterior myocardial infarction.Methods Totally 70 patients with acute myocardial infarction were selected.All the patients were conducted with routine ECG and 18-guide ECG examinations,and the diagnostic value was compared.Results According to the results of comprehensive laboratory and imaging examination,there were 28 cases diagnosed as acute posterior myocardial infarction and 42 cases diagnosed as other types of myocardial infarction.The detection rates of18-lead ECG for acute posterior myocardial infarction and other types of myocardial infarction were92.86%(26/28)and 95.24%(40/42)respectively,which were significantly higher than 67.86%(19/28)and 71.43%(30/42)by routine ECG(P<0.05).The sensitivity,specificity and accuracy of 18-lead ECG in the diagnosis of acute posterior myocardial infarction were significantly higher than those of routine ECG,and the rate of missed diagnosis and misdiagnosis was significantly lower than that of routine ECG(P<0.05).Compared with patients with other types of acute myocardial infarction,the ratios of cases with slightly decrease of V1 to V3 ST segment,slightly increase of RV1 and slightly increase of V7 to V9 ST segment were significantly higher in those with acute posterior myocardial infarction(P<0.05).Conclusion The 18-lead ECG can be used in the diagnosis of acute posterior myocardial infarction,which should be implemented in combination of the clinical symptoms and the results of myocardial enzyme spectrum detection in order to reduce rate of misdiagnosis and missed diagnosis,and increase the diagnosis rate of the disease.

关 键 词：18导联心电图 急性正后壁心肌梗死 诊断价值 心电图表现 

分 类 号：R542.2[医药卫生—心血管疾病]