肢体导联ST段改变对急性前壁心肌梗死患者冠脉闭塞部位的预测价值

目的：结合冠状动脉造影结果分析肢体导联ST段改变对判断急性前壁心肌梗死患者冠脉闭塞部位的预测价值。方法入选84例因急性前壁梗死行冠状动脉造影检查的患者，对其发病后心电图肢体导联ST段改变的情况进行分析。结果冠状动脉造影发现，前降支近端病变（伴或不伴远端病变），肢体导联Ⅱ、Ⅲ、aVF多表现为ST段压低≥0．1 mV；前降支远端病变（不伴近端病变），肢体导联Ⅱ、Ⅲ、aVF的ST段多表现为抬高或无明显压低。结论对于急性前壁心肌梗死患者，心电图肢体导联ST段改变可以预测冠状动脉闭塞部位，对早期诊断和治疗方案选择有一定的指导意义。

Clinical values of limb lead ST segment changes in predicting coronary occlusion sites in patients with acute anterior wall myocardial infarction

Objective Combining results of coronary angiography,to analyse the predictive val-ues of limb lead ST segment changes for identifying the coronary occlusion sites in patients with acute anterior wall myocardial infarction.Methods Eighty-four patients who had undergone coro-nary angiography inspections for acute anterior wall myocardial infarction were selected as candidates and their ST segment changes in limb leads of ECG after onset were analysed.Results According to the results of coronary angiography,at the lesion of the proximal end of anterior descending branch（with or without distal occlusion）,ST segment changes in limb leadsⅡ,Ⅲ,and aVF were mostly expressed as depression≥0.1 mV while elevation or unobvious depression of ST segment in limb leads Ⅱ,Ⅲ,and aVF mostly occurred at the lesion of the distal end of anterior descending branch（without proximal occlusion）.Conclusion By analysing the ST segment changes in limb leads of ECG,coronary occlusion sites can be predicted,which serves as an references for early di-agnosis and treatment options for patients with acute anterior wall myocardial infarction.