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前壁导联ST段压低与急性下壁心肌梗死冠脉病变状况及预后的关系(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第3期
页码:
318-319/325
栏目:
临床研究
出版日期:
2007-06-01

文章信息/Info

Title:
Relationship between severity of coronary artery disease, its prognosis and STsegment depression on anterior wall during acute inferior wall myocardial infarction
作者:
肖军唐发宽王龙
解放军总医院第二附属医院心内科,北京 100091
Author(s):
XIAO Jun TANG Fakuan WANG Long
Department of Cardiology, Second Affiliated Hospital, PLA General Hospital, Beijing 100091, China
关键词:
心肌梗塞下壁急性心电图ST段
Keywords:
myocardial infarctioninferioracute electrocardiogramSTsegment
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 探讨前壁导联ST段压低与急性下壁心肌梗死(MI)冠脉病变程度及预后的关系。方法 根据MI初期是否并发前壁导联ST段压低将96例急性下壁MI分为两组即前壁导联ST段压低组(A组,56例)和前壁导联ST段无压低组(B组,40例),将两组冠脉造影结果、梗死部位及预后进行比较分析。结果 A组多支血管病变(52%)、梗死相关血管近端病变(82%),下后壁MI(88%)、下后壁+右室MI(90%),心力衰竭 (16%)、心源性休克(14%)、室速(21%)。B组多支血管病变(30%)、梗死相关血管近端病变(22%),下后壁MI(12%)、下后壁+右室MI(10%),心力衰竭(2%)、心源性休克(2%)、室速(8%)。两组分项比较差异均显著(均P<0.05)。结论 并发胸前导联ST段压低的急性下壁MI多为多支血管病变,梗死相关血管多为近端病变,梗死部位多,预后不良。
Abstract:
AIM To explore the relationship between the severity of coronary artery disease, its prognosis and STsegment depression on anterior wall during acute inferior myocardial infarction (AIMI). METHODS Ninetysix patients with AIMI were divided into two groups: ST depression group (group A, n=56) and noST depression group (group B, n=40) based on STchanges in the anterior leads. The data of both groups were compared with the coronary angiographic findings, the section of myocardial infarction and prognosis. RESULTS The cases with multivessel lesions (52%), proximal lesions of infarction related artery (82%), inferiorposterior AMI (88%), inferiorposterior AMI accompanied by right ventricular infarction (90%), heart failure (16%), cardiogenic shock (14%), ventricular tachyrhythmia (21%) in group A were more than those in group B. CONCLUSION Multivessel disease, proximal lesion of infarction related artery, multisection of myocardial infarction, and poor prognosis are more likely to occur in a patient of AIMI with STsegment depression on anterior wall.

参考文献/References

[1] 龙丽萍,李晋满,古丽米拉.心肌梗死心电图新进展[J].心脏杂志,2005,17(2):157-159.

[2] 魏雪梅,张守云,孙敬春.急性下壁心肌梗死时胸导联心电图改变的临床意义[J].心脏杂志,2002,14(3):270.

[3] Rotondo N,Pollack ML,Chan TC,et al.Electrocardiographic manifestations: acute inferior wall myocardial infarction[J].J Emerg Med,2004,26(4):433-440.

[4] Bayram E,Atalay C.Identification of the culprit artery involved in inferior wall myocardial infarction using electrocardiographic criteria[J]. J Int Med Res,2004,32(1):39-44.

备注/Memo

备注/Memo:
收稿日期:2006-08-07.通讯作者:唐发宽,主任医师,主要从事冠心病临床及基础研究Email:tfk616@yahoo.com.cn 作者简介:肖军,硕士,主治医师Email:xxxjjj6288@sina.com
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