心电图改变对急性下壁心肌梗死相关血管的预测价值

目的:对急性下壁心肌梗死患者的心电图资料进行回顾性研究,分析和比较心电图改变与冠状动脉造影及临床特点的对应性关系。探讨体表心电图改变对急性下壁心肌梗死患者的临床价值。方法:选取86例急性下壁心肌梗死患者,根据冠状动脉造影结果分为右冠状动脉(RCA)病变组和左冠状动脉(LCA)病变组。对比分析其心电图改变与冠状动脉造影结果及临床特点。结果:Ⅰ、Ⅱ、Ⅲ、aVR导联ST段及aVL导联波形改变对诊断梗死相关血管具有重要价值;V3与Ⅲ导联ST段改变比值预测梗死相关血管部位具有重要价值;伴aVR导联ST段压低患者病情重;伴胸前导联ST段压低者病情重、并发症发生率明显增高。结论:心电图对诊断下壁急性心肌梗死相关血管及其临床特点具有重要的预测价值。

Predictive value of electrocardiographic changes for infarct-related artery of acute inferior myocardial infarction

AIM:To retrospectively analyze patients with inferior wall acute myocardial infarction(AMI) by electrocardiographic(ECG) data analysis,to study the relationship between changes of ECG and coronary angiography and clinical characteristics and to explore the clinical value of ECG changes in inferior wall AMI-related artery.METHODS:Eighty-six patients with inferior wall AMI were selected and divided into right coronary artery disease group and left coronary artery lesion group according to coronary angiography results.Changes of ECG and results of coronary angiography as well as clinical features were analyzed and compared between groups.RESULTS:Changes of ST segment in I,II,III aVR and aVL have more important value for diagnosis of infarct-related artery.The ratio of ST-segment changes in V3 and III has great predictive value for infarct-related artery area.ST-segment depression in aVR predicts patients with serious illness.ST-segment depression in precordium predicts patients with serious illness and complications.CONCLUSION:ECG has important predictive value in diagnosis of the artery and site of inferior wall AMI.