心电图在判断中老年急性下壁心肌梗死相关冠状动脉诊断中的应用效果评估

目的：评估心电图在判断中老年急性下壁心肌梗死相关冠状动脉的诊断价值。方法回顾分析自2012年1月—2013年12月期间该院收治的急性下壁心肌梗死患者66例。对66例患者进行冠脉造影以诊断出病变相关冠状动脉。根据病变部位将患者分为右冠状动脉（RCA）组患者（n=54）和左冠状动脉回旋支（LCX）组患者（n=12）。对两组急性下壁心肌梗死患者的心电图进行比较分析。结果 RCA组患者的心电图特征为心电图I或aVL的ST段压低，以I导联的 ST段压低≥1 mm诊断为RCA病变的敏感性和特异性分别为83.33%和75.00%以aVL导联的 ST段压低≥1 mm诊断为RCA病变的敏感性和特异性分别为87.03%和83.33%。LCX心电图特征为心电图Ⅲ和Ⅱ导联ST段压高。以心电图ⅡST段压高，于心电图Ⅲ导联为诊断LCX病变指标的敏感度和特异性为91.66%和88.88%。结论心电图在判断中老年急性下壁心肌梗死相关冠状动脉诊断中有一定指导意义。

Evaluation of the Effect of ECG Applied in the Identification of Acute Infe-rior Wall Myocardial Infarction Related Coronary Artery in Middle-aged and Elderly Patients

Objective To evaluate the diagnostic value of electrocardiogram （ECG） in identifying the acute inferior wall myocardial infarction related coronary artery in middle-aged and elderly patients. Methods 66 cases with acute inferior wall myocardial in-farction admitted in our hospital from 2012 January to 2013 December were retrospectively analyzed. Coronary angiography was performed in the 66 patients for diagnosis of the coronary artery with lesions. According to the site of lesion, the patients were di-vided into the right coronary artery （RCA） group （n=54） and the left circumflex artery （LCX） group （n=12）. And the ECG of two groups of patients with acute inferior wall myocardial infarction was compared and analyzed. Results The ECG characteristics of patients in the RCA group were as follows：ST segment of ECG of I or aVL lead decreased, ST segment in ECG of lead I decreased≥ 1 mm, the sensitivity and specificity in the diagnosis of RCA lesion was 83.33%, 75.00%, respectively; ST segment in ECG of lead aVL decreased ≥ 1 mm, the sensitivity and specificity in the diagnosis of RCA lesion was 87.03% and 83.33%, respectively. The ECG characteristics of patients in the LCX group were the elevation of ST segment in ECG of Ⅱand Ⅲ lead. The sensitivity and specificity of ECG ofⅡandⅢlead with elevation of ST segment in the diagnosis of LCX lesion was 91.66%and 88.88%, re-spectively. Conclusion ECG is of certain guiding significance in identifying the acute inferior wall myocardial infarction related coronary artery in middle-aged and elderly patients.