急性冠脉综合征容易被忽视的心电图改变  

Easily ignored ECG changes in acute coronary syndrome

作　　者：郭其凤 匡德俊 郭玲 郑婕 汤进 许祥林 GUO Qifeng;KUANG Dejun;GUO Ling;ZHENG Jie;TANG Jin;XU Xianglin(Department of Cardiology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China)

机构地区：[1]遵义医科大学附属医院心内科,贵州遵义563000

出　　处：《实用心电学杂志》2024年第1期53-58,共6页Journal of Practical Electrocardiology

摘　　要：ST段改变是目前临床上判断心肌缺血的主要指标,但因其敏感性不高,致使部分急性冠脉综合征被漏诊。而心电图上还有一些指标在判断心肌缺血上与ST段改变具有等同价值,且出现时间早于ST段改变,但因没有得到充分认识常被临床忽视,如缺血性J波、QRS波终末变形、U波倒置、胸导联T波失衡、孤立性TaVL波倒置、ST段平段延长等。本文汇集了上述几种等价指标的个案分析,旨在引起临床重视。ST-segment changes serve as primary clinical indicators for assessing myocardial ischemia at present.However,owing to their relatively low sensitivity,parts of patients with acute coronary syndrome may be missed diagnosed.Several other ECG markers could be equated with ST-segment changes in the evaluation of myocardial ischemia with earlier occurrence time.These ECG markers include ischemic J waves,terminal QRS distortion,U-wave inversion,chest lead T-wave imbalance,isolated TaVL wave inversion,and ST-segment prolongation.However,they are often ignored clinically because of being lack of comprehensive understandings.This paper presents case analyses involving these equivalent indicators,which is aimed to attract clinical attention.

关 键 词：急性冠脉综合征 心电图 缺血性J波 QRS波终末变形 U波倒置 胸导联T波失衡 孤立性TaVL波倒置 ST段平段延长 

分 类 号：R543.3[医药卫生—心血管疾病] R541.4[医药卫生—内科学]