急性下壁心肌梗死患者的临床特点分析

目的 分析研究急性下壁心肌梗死患者的临床特点. 方法 将急性下壁心肌梗死患者100例根据冠状动脉造影结果分为两组:76例为右冠状动脉(RCA)闭塞(A组),24例为左回旋支冠状动脉(LCX)闭塞(B组). 结果 心电图ST段抬高STⅢ>STⅡ及ST段压低STAVL>ST I A组显著高于B组(均P<0.05);ST段抬高STⅢ0.1 mV A组显著高于B组(P<0.05);胸前导联V1～6ST段压低患者中,合并左前降支冠状动脉(LAD)病变的患者显著高于胸前导联V1～6ST段无压低者(P<0.05);左心室射血分数(LVEF)A组(51±14)%]显著低于B组(57±10)%](P<0.05);合并右心室心肌梗死A组显著高于B组(P<0.05);急性下壁心肌梗死患者总的住院病死率6%,均为A组,但心源性休克、心力衰竭、Ⅱ、Ⅲ度房室传导阻滞,室性心动过速/心室颤动及住院病死率,两组差异均无统计学意义(均P>0.05);死亡者中心源性休克占83.3%. 结论 心电图Ⅲ、Ⅱ、I、AVL、及V4R导联ST段变化能预测急性下壁心肌梗死相关血管,急性下壁心肌梗死患者伴胸前导联ST段压低提示LAD病变,RCA闭塞所致下壁心肌梗死LVEF低于LCX闭塞者,心源性休克为死亡主要原因.

Clinical characteristics of acute inferior myocardial infarction

Objecfive To study the clinical characteristics of acute inferior myocardial infarction.Methods 100 patients with acute inferior infarction were divided into 2 groups according to coronary angiography:group A (n=76) with right coronary artery occlusion;group B(n=24) with left circumflex artery occlusion.Results The frequencies of Electrocardiogram(ECG) ST segment elevation ST Ⅲ>ST Ⅱ and ST segment depression STAVL>STI in group A was significantly higher than that in group B(P<0.05);The frequency of ECG ST segment elevation STⅢO.1 mV in group A was significantly higher than that in group B(P<0.05);The number of ECG with precor-dial lcads V1～6 ST segment depression >0.1 mv with lesion of left anterior descending coronary was more significant than that without precordial Vl-6 leads ST segment depression (P<0.05).Left ventricular ejection fraction (LVEF)(51%±14%) in group A was significant lower than that in group B(57%±10%)(P<0.05);The patients in group A with right ventricular infarction were more significant than those in group B(P<0.05);The total hospital mortality of patients with acute inferior myocardial infarction was 6%,and they were all in group A.But there was no significance between the two groups about cardiogenic shock,heart failure,Ⅱ degree and Ⅲ degree atrial ventricular b1ock,ventrieular tachycardia/ventrieular fibrillation and the hospital mortality.The mortality with cardiogenic shock was 83.3%.Conclusion The changes of ECG ST segment in Ⅲ,Ⅱ,Ⅰ,AVL and V4R leads can predict relatedinfarct coronary artery with acute inferior myocardial infarction.The patients with precordial Vl～6 leads ST segment depression indicates lesion of LAD.The LVEF of patients with RCA occlusion is lower than that with LCX occlusion. The primary cause of death is eardiogenic shock.