摘要
目的探讨体表心电图不同指标对急性下壁心肌梗死患者罪犯血管的预测价值。方法对73例急性下壁心肌梗死患者的入院心电图和冠状动脉造影资料进行回顾性分析,寻找可以预测罪犯血管[即梗死相关动脉(IRA)]的心电图改变。结果 73例急性下壁心肌梗死患者中右冠状动脉(RCA)闭塞者59例(81%),左回旋支动脉(LCx)闭塞者14例(19%)。经χ2检验,合并右室梗死、出现缓慢性心律失常、STV1抬高≥0.5mm、STⅢ抬高>STⅡ抬高、STⅠ和(或)STaVL压低≥0.5mm、V2和aVF导联ST段偏移之和>0等指标提示IRA为RCA;其中STⅠ压低≥0.5mm、STV1抬高≥0.5mm及合并右室梗死的特异度和阳性预测值最高,均达100%;灵敏度则以ST抬高Ⅲ导>Ⅱ导为最高,达81%。而预测IRA为LCX的指标中STV2压低≥0.5mm灵敏度最高,为93%,STaVL抬高≥0.5mm的特异度、阳性预测值均高达100%。结论急性下壁心肌梗死时,体表心电图对预测IRA有重要价值。
Objective To investigate the value of electrocardiogram （ECG） in identifying the guilty artery in patients with inferior wall acute myocardial infarction（AMI）. Methods By retrospective analysis of ECGs and Coronary angiographic data of 73 patients with inferior wall AMI to find valuable ECG changes that can forecast the guilty artery （also means infarct-related artery, IRA）. Results The IRAs were right coronary artery （RCA） in 59（81% ） patients and left circumflex （LCx） in 14（ 19% ） patients. By chi-square test： Combine with right ventricular infarction and serious slow arrhythmia, ST elevation in lead V1≥0.5 mm, ST elevation in lead Ⅲexceeding that of lead Ⅱ, ST depression in lead I and （or） lead aVL≥0. 5mm, sum of ST depression in lead V2 and ST elevation in lead aVF 〉 0 identified RCA occlusion. Among these criteria, ST elevation in lead Vl, ST depression in lead Ⅰ≥0.5 nun and combined with right ventricular infarction had the highest specificity and positive predictive value （PPV） of 100%, respectively, and ST elevation in lead m exceeding that of lead Ⅲ had the highest sensitivity of 81%. ST depression in lead V2≥0.5 mm had the highest sensitivity of 93%in identified LCx as IRA, and ST elevation in lead aVL≥0. 5 mm had the highest specificity and PPV of 100%,respectively. Conclusion ECG plays an important role in predicting the IRAs in patients with inferior wall AMI.
出处
《实用心电学杂志》
2011年第2期81-83,共3页
Journal of Practical Electrocardiology
关键词
急性下壁心肌梗死
心电图
冠状动脉造影
梗死相关血管
inferior wall acute myocardial infarction
electrocardiogram
coronary angiography
infarct-related artery
