心电图对急性下壁心肌梗塞时梗塞相关动脉的识别

对33例急性下壁心肌梗塞患者入院时心电图与3周内冠脉造影对照,以发现梗死相关动脉(IRA)识别方法.23例IRA为无左回旋支(LCX)狭窄的右冠状动脉(RCA)病变组V_(1-4)ST段压低16例(70%),7例无RCA狭窄的LCX病变组V_(1-4)ST段压低5例(71%),二组无显著差异;ST_Ⅱ抬高>ST_Ⅰ在RCA组15例(65%),而LCX组无1例(0%),二组有显著差异;ST_(avL)压低>ST_ⅠRCA组16例(70%)、LCX组3例(43%),二组无显著差异.RCA组V_(7-9)ST段抬高2例(9%),LCX组为5例(71%),二组差异显著,RCA组V_(4R)抬高9例(3%),LCX组无1例(0%),二组有显著差异.本文提示:ST_Ⅱ抬高>ST_Ⅰ、V_(7-9)和V_(4R)ST段抬高对急性下壁心梗时IRA识别有一定临床价值.

Electrocardiographic identification of infarction-related artery in acute inferior myocardial infarc- tion

The electrocardiograms on admission and coronary angiograms 3 weeks thereafter of 33 a-cute inferior myocardial infarction patients were studied in search of a method to identify infarction-related artery(IRA). Sixteen cases(70%) of V1-4 ST segment depression were observed in 23 cases in which IRAs were right coronary arteries (RCAs) with no left circumflex arteries (LCXs) involvement five(71%)V1-4 ST segment depression were observed in 7 cases of LCX lesions with no RCA stenosis, The difference was not significant; Fifteen(65%) in RCA group were with STⅡ elevation >STⅠ while there was none(0%) in LCX group which was of significant difference ;Sixteen patients(70%)with STavL depression > STⅠ were observed in RCA group,while 3(43%) in LCX group,while is of no significance. Elevation of ST segmentin V7-9 were notedin 2 RCA(9%) patients,while 5(71%) in LCX group, the difference was signfcant; ST segment elevation in V4R Were noted in 9 (39%), while none in LCX group, there lied a significant difference between 2 group. we suggest STⅠ elevation >ST11111111111 ,ST elevationin V7-9 and V4R may be of diagnostic value in identifying IRA in acute inferior myocardial infarction.