急性下壁心肌梗死ST段改变与相关冠状动脉阻塞的关系  

Relationship between ST segment change of acute inferior myocardial infarction and coronary occlusion

作　　者：刘淑君[1] 周■ 侯红霞[1] 朱源生[2] 方翔[2] 周亚林[2] 

机构地区：[1]江苏省淮安市第二人民医院心电图室 [2]江苏省淮安市第二人民医院心血管科

出　　处：《心电学杂志》2003年第3期139-140,共2页Journal of Electrocardiology(China)

摘　　要：目的探讨急性下壁心肌梗死时心电图ST段改变与相关冠状动脉阻塞的关系。方法对30例急性下壁心肌梗死ST段改变与冠状动脉造影结果对比分析。结果急性心肌梗死部位下壁12例、下壁+正后壁5例、下壁+右心室8例、下壁+前壁5例。其中单支病变10例,双支病变12例,三支病变8例。右冠状动脉狭窄87.7%,左回旋支狭窄12.2%。ST段抬高Ⅲ>Ⅱ,压低aVL>Ⅰ,诊断右冠状动脉阻塞,敏感性、特异性分别为95.0%、93.4%。V4导联ST段压低与Ⅲ导联ST段抬高比值>0.5,可诊断左回旋支阻塞,敏感性、特异性分别为84.9%和79.4%,ST段抬高Ⅰ>aVL、压低Ⅱ>Ⅲ,提示左回旋支阻塞,敏感性、特异性分别为52.1%和78%。结论急性下壁心肌梗死心电图ST段抬高Ⅲ>Ⅱ、ST段压低aVL>Ⅰ,提示右冠状动脉阻塞,V4导联ST段压低与Ⅲ导联ST段抬高比值>0.5,ST段抬高Ⅰ>aVL、ST段压低Ⅱ>Ⅲ,提示左回旋支阻塞。Objective To study relationship between ST segment change of acute inferior myocardial infarction and coronary occlusion. Methods To study 30 cases of acute inferior myocardial infarctions ST segment change , and compare with coronary angiography. Results Acute inferior myocardial infarction 12 cases, inferior and posterior 5 cases, inferior and right ventricular 8 cases, inferior and entrecote 5 cases, branch of simple 10 cases, two branch of artery change 12 cases, three branch of artery 8 cases, right coronary occlusion 87.7%, circumflex branch 12.2%.In diagnostic of right coronary occlusion, elevate of ST segment Ⅲ>Ⅱ, ST segment depression aVL>Ⅰ, sensitivity 9.5%, specificity 93.4%. In circumflex branch occlusion V4 ST segment depression Ⅲ elevate of segment>0.5 sensitivity 84.9% , specificity 79.4%.Elevate of ST segmentⅠ >aVL , ST segment depression Ⅱ>Ⅲ sensitivity 52.1%, specificity 78%. Conclusion In patients of acute inferior myocardial infarction, elevate of ST segment Ⅲ>Ⅱ, ST segment depression aVL>Ⅰ,implicated occlusion of right coronary artery,V4 ST segment depression Ⅲ elevate of segment > 0.5,elevate of ST segment Ⅰ>aVL ,ST segment depression Ⅱ>Ⅲ, implicated occlusion of circumflex branch.

关 键 词：急性下壁心肌梗死 ST段改变 相关冠状动脉阻塞 心电图 冠状动脉造影 

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