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aVL导联预测急性下壁心肌梗死相关动脉的价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第1期
页码:
43-44
栏目:
临床研究
出版日期:
2003-01-01

文章信息/Info

Title:
The lead aVL for predicting the culprit artery in inferior wall acute myocardial infarction
作者:
张录兴; 郑强荪; 何勇; 李志立; 金葵花
第四军医大学唐都医院心内科,陕西 西安 710038
Author(s):
ZHANG Lu-xing; ZHENG Qiang-sun; HE Yong; LI Zhi-li; JIN Kui-hua
Department of Cardiology,Tang du Hospital,Fourth Military Medical University,Xi'an,Shaanxi 710038,China
关键词:
梗死相关动脉; 心肌梗塞; 急性; 下壁; 心电描记术
Keywords:
infarction related artery;  myocardial infarction;  acute;  inferior wall;  electrocardiography
分类号:
R542.22
DOI:
-
文献标识码:
A
摘要:
目的:根据心电图aVL导联预测急性下壁心肌梗死相关动脉的价值。方法:根据冠状动脉造影结果将49例下壁急性心肌梗死患者分为右冠状动脉闭塞组34例和左冠状动脉回旋支闭塞组15例。根据aVL导联QRS形态分为A型(R≥3S,ST段压低≤1mm)和B型(R<3S,ST段压低>1mm)。结果: 左冠状动脉回旋支闭塞时, aVL导联呈A型变化。其敏感度和特异性分别为80.0%和79.4%;右冠状动脉闭塞时,多呈B型变化。其敏感度和特异性分别为79.4%和80.0%。结论: 下壁急性心肌梗死患者的心电图aVL导联QRS波呈A型者是左冠状动脉回旋支闭塞的敏感、特异性标志;呈B型者是右冠状动脉闭塞的敏感、特异性标志。
Abstract:
AIM: The aim of this study is to investigate the lead aVL for predicting the culprit artery in inferior wall acute myocardial infarction (AMI). MEHTODS: According to the features of electrocardiogram (ECG) in lead aVL, patients were divided into pattern A (R≥3S, ST-segment depression≤1mm) and pattern B (R<3S,ST-segmentdepression>1mm). Infarction related arteries (IRA) were divided into entities of right coronary artery (RCA) (34cases) or left circum flex artery (LCX) (15cases) confirmed by coronary arteriography in 49 patients with inferior wall AMI. RESULTS: The incidence of pattern A was higher in LCX group than that in RCX group (P<0.05), with the sensitivity and specificity of 80.0% and 79.4% respectively in predicting occlusion of LCX. The incidence of pattern B was higher in RCA group than that in LCX group (P<0.05) with the sensitivity and specificity of 79.4% and 80.0% respectively in predicting occlusion of RCA. COCLUSION: Pattern A of the QRS complexin lead aVL is a sensitive and specific marker for LCX artery occlusion, where as pattern B suggests RCA related AMI diseases.

参考文献/References

[1] Sgarbossa EB, Bimbaum Y, Parrillo JE. Electrocardiographic diagnosis of acute myocardia infarction: current concepts for the clinician [J] . Am Heart J, 2001, 141:507-512.

[2] Hasdai D, Bimbaum Y, Hera L, et al. ST segmemt depression in lateral limb leads in inferior wall acute myocardial infarction: implicalion regarding the culprit artery and the site of obstruclion [J]. Eur Heart J, 1995, 16:1549-1553.

[3] Bimbaum Y, Hale SL, Kloner RA. Changes in the R wave amplitude: electrocardiographic differentiation between episodes of reocclusion and reperfusion associated with ST segment elevation [J]. JE lectrocardial, 1997, 30:211-216.

备注/Memo

备注/Memo:
收稿日期：2002-07-18.
更新日期/Last Update: 2003-01-01