摘要
目的:证实用标准12导联心电图中III导联ST段抬高变化幅度与Ⅱ导联ST段抬高变化幅度的比值≥1诊断下壁合并右室心肌梗死的临床诊断价值。方法:对21例根据临床表现,并经冠脉造影证实的急性下壁合并右心室心肌梗死的Ⅲ导联ST段抬高变化幅度与Ⅱ导联ST段抬高变化幅度的比值,评价该比值≥1在急性下壁合并右心室心肌梗死的诊断价值。结果:21例患者的临床症状除有典型的下壁心肌梗死表现外,还有低血压甚至心源性休克等右心室衰竭的症状,经冠状动脉造影证实符合下壁合并右室心肌梗死的诊断。19例心电图中Ⅲ导联ST段抬高变化幅度与Ⅱ导联ST段抬高变化幅度的比值>1;其中16例右胸导联V3R～V6R导联ST段抬高变化幅度>0.1mV,3例ST段抬高但幅度<0.1mV。2例心电图中Ⅲ导联ST段抬高变化幅度与Ⅱ导联ST段抬高变化幅度的比值=1;右胸导联V3R～V6R导联中QRS呈qr型,ST段抬高但幅度<0.1mV。结论:用常规12导联心电图中III导联ST段抬高变化幅度与Ⅱ导联ST段抬高变化幅度的比值≥1,结合临床表现、心肌酶谱的变化以及右胸导联心电图的变化对诊断下壁合并右室心肌梗死具有较好的临床应用价值。
Obiective To confirm the value of ST segment elevation range in lead III and II lead ratio ≥1 in the diagnosis of inferior and right ventricular myocardial infarction.Methods 21 patients with acute inferior and right ventricular myocardial infarction were confirmed by clinical manifestations and coronary angiography.To evaluate the value of ST segment elevation range in lead III and II lead ratio≥1 in the diagnosis of inferior and right ventricular myocardial infarction.Results 21 patients had typical clinical symptoms of inferior myocardial infarction performance,campanied with hypotension or even cardiogenic shock,right ventricular failure symptoms,were confirmed by coronary angiography to be inferior and right ventricular myocardial infarction.ECG in 19 patients were ST segment elevation range in lead III and II lead ratio1,including 16 with right chest leads V3R～V6R leads ST segment elevation range0.1mV,and 3 with ST segment elevation range0.1mV.ECG in 2 cases were ST segment elevation range in lead III and II lead ratio=1,right chest leads V3R～V6R leads were the qr-type QRS,ST segment elevation but the magnitude is0.1mV.Conclusion It has a good Clinical value in the diagnosis of inferior and right ventricular myocardial infarction that the routine 12-lead ECG ST segment elevation range in lead III and II lead ratio≥1,clinical performance,changes in myocardial enzymes and ECG changes of right chest lead.
出处
《新疆医学》
2011年第4期3-5,共3页
Xinjiang Medical Journal
关键词
12导联心电图
下壁
右心室
心肌梗死
12-lead ECG
inferior
right ventricular
myocardial infarction
