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|本期目录/Table of Contents|

心电图在急性下壁心肌梗死相关动脉判定中的意义(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2000年第1期
页码:
25-27, 30
栏目:
论著
出版日期:
2000-01-25

文章信息/Info

Title:
Usefulness of the electrocardiogram for indentifying the infarct-related artery in inferior wall acute myocardial infarction
作者:
程何祥;  陈士良;  李伟;  贾国良;  李兰荪;  曹艳杰
第四军医大学西京医院心内科, 陕西 西安 710032
Author(s):
CHENG He-xiang;  CHEN Shi-liang;  LI Wei;  JIA Guo-liang;  LI Lan-sun;  CAO Yan-jie
Department of Cardiology,Xijing Hospital, Fourth Military Medical University,Xi’an 710032, Shaanxi,China
关键词:
心肌梗死; 下壁; 急性; 动脉; 梗死相关; 心电图
Keywords:
myocardial infarction;  inferior wall;  acute;  Artery;  infarct-related;  Electrocardiogram
分类号:
R540.41; R542.22
DOI:
-
文献标识码:
A
摘要:
目的 探讨应用心电图判断急性下壁心肌梗死患者梗死相关动脉(IRA)的可行性与准确性. 方法 回顾性分析36例首次急性下壁心肌梗死患者的入院心电图与冠状动脉造影资料. 结果 急性下壁心肌梗死患者多有右冠状动脉(RCA)病变（88.6%），多数（66.7%）患者有两支以上病变。IRA的分布也是RCA多于左旋支(LCX), 分别占86.1%和13.9%。对心电图指标(STⅠ,STaVL,STV1或V2,STV2+aVF,STV2+Ⅲ,STV5或V6,STⅡ/Ⅲ)与IRA关系的统计分析表明，前五组未出现显著差异。STV5或V6在RCA组多为下降，LCX组多为抬高而无1例下降（P＜0.05）；但排除RCA和LCX皆有显著病变的病例后P＞0.05。STⅡ/Ⅲ在RCA组绝大多数小于1而LCX组多大于1(P＜0.01)；排除RCA和LCX皆有显著病变的病例后仍然P＜0.01。结论 STⅡ/Ⅲ比值是判断急性下壁心肌梗死患者IRA的较准确的心电图指标。
Abstract:
AIM To investigate value of the electrocardiogram in predicting the infarct-related artery(IRA) in inferior wall acute myocardial infarction. METHODS The early electrocardiogram and coronary angiographic findings were retrospectively analyzed in 36 patients with first time inferior wall acute myocardial infarction. RESULTS The right coronary artery (RCA) lesion existed in most inferior wall acute myocardial infarctions (88.6%). The ratio of RCA to the total number of infarct-related arteries (IRA) was much higher than that of the left circumflex artery (LCX) (86.1% versus 13.9%).No significant correlation with IRA was found in STⅠ, STaVL, STV1 or V2,STV2+aVF and STV2+Ⅲ groups. Patients having the RCA as IRA were significantly more likely to have ST depression in leads V5 or V6,whereas patients having the LCX as LRA were significantly more likely to have ST elevation in leads V5 or V6 (P＜0.05). After the patients with distinct lesion in both arteres were excluded, the significance disappeared (P＞0.05).The STⅡ/Ⅲ ratio was ＞1 in most cases of the RCA group, whereas it was ＜1 in most cases of the LCX group (P＜0.01).After the 17 patients with distinct lesion in both arteres were excluded, the p value was almost the same (P＜0.01). CONCLUSION The STⅡ/Ⅲratio is an accurate electrocardiographic criteria for predicting IRA in inferior wall acute myocardial infarction.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：1999-01-19.
更新日期/Last Update: 2000-01-25