摘要
目的:探讨心电图在判断下壁急性心肌梗死(AMI)中梗死相关血管(IRA)和预测患者住院期间心脏事件中的价值,方法:选择经冠状动脉造影确诊的下壁AMI患者163例.观察其心电图表现与冠状动脉造影、住院期间心脏事件的关系。结果:163例下壁AMI患者中,右冠状动脉(RCA)病变112例,左回旋支(LCX)病变51例。以RCA病变为主时,心电图表现为Ⅲ导联ST段抬高幅度>Ⅱ导联ST段抬高幅度、aVL导联ST段压低和aVR导联ST段抬高:LCX病变心电图多表现为Ⅲ导联ST段抬高幅度<Ⅱ导联ST段抬高幅度、aVL导联ST段抬高和aVR导联ST段压低Ⅲ导联ST段抬高幅度>Ⅱ导联ST段抬高幅度,则提示合并有心室AMI及缓慢性心律失常的发生率高于Ⅲ导联ST段抬高幅度<Ⅱ导联ST段抬高幅度者。结论:临床医师可通过心电图上的ST段移位对AMI患者的IRA作出初步判断,并评估其预后。
Objective To evaluate the value of ECG in the prediction of infarction related coronary artery （IRA） and assessment of prognosis in patients with acute inferior myocardial infarction. Methods Relationship between the results from ECG and coronary angiography, cardiac event during hospitalization were observed in 163 patients with acute inferior myocardial infarction. Results Of these 163 cases with acute inferior myocardial infarction, 112 cases had lesions of right coronary artery （RCA）, 51 cases had lesions of left circumflex coronary artery （LCX）. When RCA was the main infarction related coronary artery, ST elevation in lead m was greater than ST elevation in lead Ⅱ, ST depression in aVL and ST elevation in lead aVR. When LCX was the infarction related artery, ECG mostly expressed as ST elevation in lead m less than ST elevation in lead Ⅱ, ST elevation in aVL and ST depression in aVR. ST elevation in lead m greater than ST elevation in lead Ⅱ denoted the incidence of association with right ventricular infarction and bradycardia-arrhythmia was higher than those with ST elevation in lead m less than ST elevation in lead Ⅱ. Conclusions ST segment shift in ECG could be used to predict the IRA and assess the prognosis of patients with acute inferior myocardial infarction.
出处
《诊断学理论与实践》
2008年第4期390-393,共4页
Journal of Diagnostics Concepts & Practice
基金
美国飞利浦医疗部高级算法研究中心资助
关键词
急性心肌梗死
心电图
右冠状动脉
左回旋支动脉
Acute myocardial infarction
Electrocardiogram
Right coronary artery
Left circumflex coronary artery
