急性下壁心肌梗死伴有胸前导联ST段压低的临床意义

目的 分析急性下壁心肌梗死（acute inferior myocardial infarction，AIMI）伴有胸前导联ST段压低的冠状动脉病变特点及临床意义。方法 回顾分析2006年8月～2007年8月住院的AIMI患者91例。按胸前导联ST段是否压低将患者分为4组:胸前导联ST段无压低组（n=27）;胸前导联仅V1～4 ST段压低组（n=26）;胸前导联仅V5～6 ST段压低组（n=12）；广泛胸前导联ST段压低组（n=26）。结果 AIMI伴有胸前导联V1～4 ST段压低与冠状动脉多支病变呈负相关，ORⅢ=0.38,无统计学意义；AIMI伴有胸前导联V1～6 ST段压低与冠状动脉多支病变呈正相关，ORⅣ=5.25,P<0.01,有显著统计学意义。胸前导联V1～6 ST段压低组与其他组相比较，左室射血分数（LVEF）低，差异显著（P<0.05）；该组前降支病变率高（73.1%），但与其他3组相比无统计学差异。结论 AIMI伴有胸前导联V1～6 ST段压低提示多支病变,且心功能不全发生率高。

Clinical implication of precordial ST segment depression in patients with acute inferior myocardial infarction

AIM: To investigate the relationship between coronary lesion characteristics and precordial ST segment depression and its clinical implication in patients with acute inferior myocardial infarction (AIMI). METHODS: Ninety one patients with the first AIMI were divided into four groups on the basis of admission electrocardiograms: Group I—patients with no precordial ST segment depression (n=27), Group II—patients with ST segment depression in leads V1 to V4 (n=26), Group III—patients with ST segment depression in leads V5-V6 (n=12) and Group IV of patients with ST segment depression in leads V1-V6 (n=26). RESULTS: V1-V4 ST segment depression in AIMI was negatively correlated with multivessel lesion (ORIII=0.38, P>0.05), whereas V1-V6 ST segment depression in AIMI was positively correlated with multivessel lesion (ORIV=5.25, P<0.01) and lower left ventricular ejection fraction (P<0.01). CONCLUSION: V1-V6 ST segment depression in AIMI suggests higher incidence of multivessel lesion and heart failure.