急性下壁心肌梗死伴有胸前导联ST段压低的临床意义 |
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引用本文: | 富路,张师义,屈昌芝. 急性下壁心肌梗死伴有胸前导联ST段压低的临床意义[J]. 心脏杂志, 2009, 21(4): 547-549 |
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作者姓名: | 富路 张师义 屈昌芝 |
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作者单位: | 哈尔滨医科大学附属第一临床学院心内科,黑龙江 哈尔滨 150001 |
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摘 要: | 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。
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关 键 词: | 心肌梗死 急性 下壁 胸前导联ST段压低 冠状动脉多支病变 |
Clinical implication of precordial ST segment depression in patients with acute inferior myocardial infarction |
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Abstract: | 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. |
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